Heesacker, Roberta S.; Neimeyer, Greg J.
Investigated relation between eating disorder and disturbances in object relations and cognitive structure in undergraduate female college students (n=183). Results indicated that eating disorder was predicted by measures of object relations disturbance and cognitive structure. (Author/ABL)
Fitzsimmons-Craft, Ellen E; Keatts, Dara A; Bardone-Cone, Anna M
This study examined the relation between eating expectancies, assessed via the Eating Expectancy Inventory, and eating disorder recovery. Individuals formerly seen for an eating disorder were categorized as having an active eating disorder ( n = 53), as partially recovered ( n = 15), or as fully recovered ( n = 20). The expectancies of these groups were compared to each other and to 67 non-eating disorder controls. Results revealed that three of the five eating expectancies differed across groups. Non-eating disorder controls and fully recovered individuals endorsed similar levels of the expectancies that eating helps manage negative affect, eating is pleasurable and useful as a reward, and eating leads to feeling out of control. Partially recovered individuals looked more similar to active eating disorder cases on these expectancies. The other two expectancies did not differ across groups. Results provide some indication that certain eating expectancies may be associated with eating disorder recovery.
Webb, C M; Thuras, P; Peterson, C B; Lampert, J; Miller, D; Crow, S J
Although previous research has supported the importance of anxiety as an etiological and maintenance factor for eating disorders, the specific mechanisms are not well understood. The role of anxiety in the context of eating behavior is especially unclear. The purpose of this study was to identify anxiety-eliciting eating situations and anxiety management strategies patients use to mitigate anxiety experienced in the context of eating as determined by diagnostic groups and symptom patterns. Fifty-three eating disorder outpatients were administered the Eating and Anxiety Questionnaire (EAQ) and the Eating Disorder Diagnostic Scale. Ratings indicated significant anxiety in most eating situations, whereas management strategies were more limited yet regularly employed. Factor analysis of the EAQ revealed a 6-factor solution for anxiety management strategies and a 4-factor solution for anxiety-eliciting situations. These results indicate patients with eating disorders report high levels of anxiety associated with eating behaviors but utilize limited yet consistent anxiety management strategies. Effective intervention strategies for managing eating-related anxiety should be incorporated into treatment and may need to be specified for different diagnostic subgroups.
Bardone-Cone, Anna M; Butler, Rachel M; Balk, Margaret R; Koller, Katherine A
Impulsivity is associated with eating pathology, but different dimensions of impulsivity have not been extensively studied in the eating disorders. The current study examined the relationship between four facets of impulsivity and eating disorder recovery status. Females formerly seen for an eating disorder were categorized as having an eating disorder (n = 53), partially recovered (n = 15), or fully recovered (n = 20) based on a diagnostic interview and physical, behavioral, and psychological indices. These groups and non-eating disorder controls were compared on impulsivity facets from the UPPS Impulsive Behavior Scale (UPPS): Urgency (negative urgency), Premeditation (lack of), Perseverance (lack of), and Sensation Seeking. Negative urgency (the tendency to engage in impulsive behavior to alleviate negative affect) was related to recovery. The fully recovered group and controls experienced significantly less negative urgency than those with a current eating disorder; the partially recovered group did not differ from the eating disorder group. Findings suggest that negative urgency may be a particularly important facet of impulsivity to target in therapeutic intervention for eating disorders, especially among those with a history of binge eating and/or purging. Future longitudinal work is needed to test a potential causal relationship between negative urgency and eating disorder recovery. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1027-1031). © 2016 Wiley Periodicals, Inc.
Brewster, David H; Nowell, Siân L; Clark, David N
It has been suggested that the risk of oesophageal adenocarcinoma might be increased in patients with a history of eating disorders due to acidic damage to oesophageal mucosa caused by self-induced vomiting practiced as a method of weight control. Eating disorders have also been associated with risk factors for squamous cell carcinoma of the oesophagus, including alcohol use disorders, as well as smoking and nutritional deficiencies, which have been associated with both main sub-types of oesophageal cancer. There have been several case reports of oesophageal cancer (both main sub-types) arising in patients with a history of eating disorders. We used linked records of hospitalisation, cancer registration and mortality in Scotland spanning 1981-2012 to investigate the risk of oesophageal cancer among patients with a prior history of hospitalisation with eating disorder. The cohort was restricted to patients aged ≥10 years and eating disorder. Disregarding the first year of follow-up, we calculated indirectly standardised incidence ratios using the general population as the reference group to generate expected numbers of cases (based on age-, sex-, socio-economic deprivation category-, and calendar period-specific rates of disease). After exclusions, the cohort consisted of 3617 individuals contributing 52,455 person-years at risk. The median duration of follow-up was 13.9 years. Seven oesophageal cancers were identified, as compared with 1.14 expected, yielding a standardised incidence ratio of 6.1 (95% confidence interval: 2.5-12.6). All were squamous cell carcinomas arising in females with a prior history of anorexia nervosa. Patients hospitalised previously with eating disorders are at increased risk of developing oesophageal cancer. Confounding by established risk factors (alcohol, smoking, and nutritional deficiency) seems a more likely explanation than acidic damage through self-induced vomiting because none of the incident cases of oesophageal cancer were
Amin, Reena; Strauss, Clara; Waller, Glenn
Different body-related behaviours and cognitions (checking, avoidance, comparison, display) have been shown to be related to unhealthy eating attitudes in a non-clinical sample. This study tested whether the use of body-related behaviours is higher in eating-disordered women than in non-clinical women. It also examined whether the use of body-related behaviours is associated with psychological characteristics (particularly anxiety, depression and narcissistic characteristics), controlling for age and eating pathology. Ninety-nine adult women with diagnosed eating disorders (mean age = 30.4 years, SD = 9.44; mean body mass index = 21.9, SD = 6.39) completed standardized measures of eating pathology, anxiety and depression, narcissistic characteristics, and body-related behaviours and cognitions. The Body-Related Behaviours Scale (BRBS) had acceptable levels of internal consistency in this group, and its scales were only weakly to moderately correlated with each other. There were no differences between diagnostic groups, but the clinical group had higher scores that a previous non-clinical sample on three of the scales. The four body-related behaviours had different patterns of association with eating pathology, depression and narcissistic features. However, anxiety was not associated with BRBS scores. The findings support the importance of a wide range of body-related behaviours and cognitions in understanding the eating disorders. However, the lack of an association with anxiety is counter to the suggestion that the various behaviours measured by the BRBS reflect safety behaviours on the part of sufferers. Depression and narcissistic features might be more important in maintaining such behaviours.
Padierna, A; Quintana, J M; Arostegui, I; Gonzalez, N; Horcajo, M J
This study investigated the perception of health-related quality of life (HRQoL) in ambulatory patients with eating disorders in relation to the severity of eating symptomatology and psychological comorbidity. One hundred ninety-seven study patients were consecutively recruited at the Eating Disorders Outpatient Clinic. Short Form-36 items (SF-36), a generic HRQoL questionnaire, the Eating Attitudes Test (EAT-40), and the Hospital Anxiety and Depression Scale (HAD) were used to measure different aspects of HRQoL. The results of the SF-36 were compared with the norms of the Spanish general population for women 18-34 years of age. Patients with eating disorders were more dysfunctional in all areas of the SF-36 compared with women in the general population. There were no differences among the eating disorder diagnostic groups. Higher scores on the EAT-40 and the HAD were associated with a perception of greater impairment on all SF-36 subscales. The evaluation of HRQoL in these patients confirms the impact of these disorders on daily life in areas not directly related to eating disorders. The SF-36 is useful for discriminating among different levels of severity of eating disorders and other psychological comorbidities of these patients.
Valiensi, Stella Maris; Cristiano, Edgardo; Martínez, Oscar A; Reisin, Ricardo C; Alvarez, Florencia
Zolpidem is a hypnotic drug used in sleep disorders. It binds selectively to alpha 1 subunit of the GABA A benzodiazepine receptor. Zolpidem reduces sleep latency, number of arousals and increases the total time of sleep. However, it is considered that it may increase phase 3 of non rapid eye movement sleep, where somnambulism can take place. Our aim is to report 8 cases of sleep related eating disorders associated with the use of this drug. We have evaluated the medical history of 8 patients who had received zolpidem for sleeping disorders and who have presented sleep related eating disorders. Eight patients (6 women, 2 men) aged between 32 to 72 years old, which received 10 mg of zolpidem/night except 1 that received 12.5 mg, were presented. They have referred strange eating behavior compatible to sleep related eating disorder. Symptoms appeared at a mean of 39.8 days after starting the medication. The numbers of nocturnal episodes recorded by the family or by the patient were 1 to 8 episodes of nocturnal eating per night. The morning after, patients found leftovers from the night before which they did not recall to have eaten. The remission was complete after discontinuing zolpidem. Zolpidem may induce sleep related eating disorder in about 1% of patients, although we consider there may be a subdiagnosis of this phenomenon. It will be important to bear in mind and look for this side effect because all the episodes could easily be controlled by withdrawing the drug.
Sandberg, Rita Marie; Dahl, Jens K.; Vedul-Kjels?s, Einar; Engum, Bj?rnar; Kulseng, B?rd; M?rvik, Ronald; Eriksen, Lasse
Objective. To study health-related quality of life (HRQoL) in obese presurgery patients with binge eating disorder (BED) and with subdiagnostic binge eating disorder (SBED) compared to patients without eating disorders or SBED. Method. Participants were patients referred to St. Olavs University Hospital, Norway, for bariatric surgery. Eating Disorders in Obesity (EDO) questionnaire was used to diagnose BED and SBED. Short-Form Health Survey (SF-12) assessed health-related quality of life. Que...
Sayed Shahabuddin Hoseini
Full Text Available Night eating syndrome is a common disorder in eating behaviors that occurs in close relation to the night time sleep cycle. Although eating disorders are common in society, night eating syndrome has been left neglected by health care professionals. In this report we present a case of eating disorder that exhibits some novel features of night eating syndrome. Our case was a progressed type of eating disorder which may increase awareness among physicians about sleep-related eating disorders.
Sayed Shahabuddin Hoseini; Zhamak Khorgami; Ahmad Reza Dehpour; Nasrin Shoar; Mohammad Naderan; Saeed Shoar
Night eating syndrome is a common disorder in eating behaviors that occurs in close relation to the night time sleep cycle. Although eating disorders are common in society, night eating syndrome has been left neglected by health care professionals. In this report we present a case of eating disorder that exhibits some novel features of night eating syndrome. Our case was a progressed type of eating disorder which may increase awareness among physicians about sleep-related eating disorders.
Shoar, Saeed; Naderan, Mohammad; Shoar, Nasrin; Dehpour, Ahmad Reza; Khorgami, Zhamak; Hoseini, Sayed Shahabuddin
Night eating syndrome is a common disorder in eating behaviors that occurs in close relation to the night time sleep cycle. Although eating disorders are common in society, night eating syndrome has been left neglected by health care professionals. In this report we present a case of eating disorder that exhibits some novel features of night eating syndrome. Our case was a progressed type of eating disorder which may increase awareness among physicians about sleep-related eating disorders.
Webb, CM; Thuras, P; Peterson, CB; Lampert, J; Miller, D; Crow, SJ
Although previous research has supported the importance of anxiety as an etiological and maintenance factor for eating disorders, the specific mechanisms are not well understood. The role of anxiety in the context of eating behavior is especially unclear. The purpose of this study was to identify anxiety-eliciting eating situations and anxiety management strategies patients use to mitigate anxiety experienced in the context of eating as determined by diagnostic groups and symptom patterns. Fi...
... and Bulimia What Causes Eating Disorders? Sports and Eating Disorders Effects of Eating Disorders Treatment for Eating Disorders Print ... when they are biologically destined to gain it. Effects of Eating Disorders Eating disorders are serious medical illnesses. They often ...
Eating disorder - binge eating; Eating - binge; Overeating - compulsive; Compulsive overeating ... as having close relatives who also have an eating disorder Changes in brain chemicals Depression or other emotions, ...
This thesis deals with the problems of eating disorders. Objective of the thesis is definition of eating disorder, a description of the individual faults an as a practical part there is an artistic creation of specific disorders. Theoretical part includes characteristics, division and insight into history. There are described four forms of eating disorders: anorexia, bulimia, obesity and bigorexia. In the practical part is the visual processing of transformation of two excessive eating disord...
Kobayashi, Nobuyuki; Takano, Masahiro
Sleep-related eating disorder is characterized by parasomnia with recurrent episodes of nocturnal eating or drinking during the main sleep period. Several drugs, including atypical antipsychotics, induce sleep-related eating disorder. However, aripiprazole has not previously been associated with sleep-related eating disorder. A 41-year-old Japanese man visited our clinic complaining of depression. The patient was treated with sertraline, which was titrated up to 100 mg for 4 weeks. A sleep inducer and an anxiolytic were coadministered. His depressive mood slightly improved, but it continued for an additional 4 months. Subsequently, aripiprazole (3 mg) was added as an adjunctive therapy. After 3 weeks, the patient's mother found that the patient woke up and ate food at night. The next morning, the patient was amnesic for this event, felt full, and wondered why the bags of food were empty. This episode lasted for 2 days. The patient gained 5 kg during these 3 weeks. After the aripiprazole dose was reduced to 1.5 mg, the patient's nocturnal eating episodes rapidly and completely disappeared. To the best of our knowledge, this is first report of sleep-related eating disorder induced by aripiprazole, and it indicates that this disorder should be considered a possible side effect of aripiprazole. Although aripiprazole is used mainly in patients with schizophrenia, its recently documented use as an adjunctive therapy in patients with depression might induce hitherto unknown side effects.
Lavender, Jason M; Mason, Tyler B; Utzinger, Linsey M; Wonderlich, Stephen A; Crosby, Ross D; Engel, Scott G; Mitchell, James E; Le Grange, Daniel; Crow, Scott J; Peterson, Carol B
This study examined personality and affective variables in relation to eating disorder symptoms in anorexia nervosa (AN). Women (N=118) with DSM-IV AN completed baseline questionnaires (Beck Depression Inventory, Frost Multidimensional Perfectionism Scale) and interviews (Eating Disorder Examination, Yale-Brown-Cornell Eating Disorder Scale), followed by two weeks of ecological momentary assessment (EMA) involving multiple daily reports of affective states and eating disorder behaviors. Hierarchical regression analyses were conducted using eating disorder symptoms as dependent variables (i.e., EMA binge eating, EMA self-induced vomiting, eating disorder rituals, eating disorder preoccupations, dietary restraint). Predictor variables were maladaptive perfectionism (baseline), depressive symptoms (baseline), and affect lability (EMA). Results revealed that affect lability was independently associated with binge eating, whereas depressive symptoms were independently associated with self-induced vomiting. Depressive symptoms were independently associated with eating disorder rituals, whereas both depressive symptoms and maladaptive perfectionism were independently associated with eating disorder preoccupations. Finally, maladaptive perfectionism and affect lability were both independently associated with dietary restraint. This pattern of findings suggests the importance of affective and personality constructs in relation to eating disorder symptoms in AN and may highlight the importance of targeting these variables in the context of treatment. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
... weight loss. With anorexia, a person will deny hunger and refuse to eat, practice binge eating and ... to better insure healthy eating patterns, and increases awareness and support. Related Conditions People with eating disorders ...
Fitzsimmons, Ellen E.; Bardone-Cone, Anna M.; Kelly, Kathleen A.
In Western society, the feminine body has been positioned as an object to be looked at and sexually gazed upon; thus, females often learn to view themselves as objects to be observed (i.e., objectified body consciousness (OBC)). This study examined the relation between OBC and eating disorder recovery by comparing its components across non-eating disorder controls, fully recovered, partially recovered, and active eating disorder cases. Results revealed that non-eating disorder controls and fully recovered individuals had similarly low levels of two components of OBC, body surveillance and body shame. Partially recovered individuals looked more similar to those with an active eating disorder on these constructs. The third component of OBC, control beliefs, and a conceptually similar construct, weight/shape self-efficacy, did not differ across groups. Results provide support for the importance of measuring aspects of self-objectification, particularly body surveillance and body shame, across the course of an eating disorder. PMID:22051364
Pawłowska, Beata; Małaj, Grzegorz; Szpakowska, Aneta; Buczyjan, Alina
The aim of the study was to compare of the D.M. Garner, M.P. Olmsted and J. Polivy Eating Disorders Inventory (EDI) results obtained by healthy lower secondary, secondary and college students versus the results obtained with their peers with eating disorders. The examined group consisted of 379 girls attending Lublin lower secondary schools (123 persons), secondary schools (50 persons) and college students (206 persons) as well as 90 girls undergoing medical treatment due to eating disorders (30 lower secondary school students and 30 college students). All these persons were administered the D.M. Garner, M.P. Olmsted and J. Polivy Eating Disorders Inventory (EDI). The tests conducted revealed significant statistical differences between the Eating Disorders Inventory (EDI) results obtained by secondary school students and college students with eating disorders and those obtained by their healthy peers as well as the lack of significant differences between healthy and ill lower secondary school students. 1. Age is a significant factor related to eating disorders. 2. As regards their attitude in relation to eating and their own body, healthy lower secondary school students are not much different from their peers diagnosed with eating disorders. 3. Incorrect attitudes in relation to eating and their own body in girls with eating disorders increase in a significant way at secondary school and at college periods.
Harney, Megan B.; Fitzsimmons-Crafr, Ellen E.; Maldonado, Christine R.; Bardone-Cone, Anna M.
The purpose of this study was to examine a collection of negative affect symptoms in relation to stages of eating disorder recovery. Depressive symptoms, anxiety symptoms, loneliness, and perceived stress are known to be present in individuals with eating disorders; however, less is known about the presence of such constructs throughout the recovery process. Does this negative affect fog continue to linger in individuals who have recovered from an eating disorder? Female participants seen at some point for an eating disorder at a primary care clinic were categorized into one of three groups using a stringent definition of eating disorder recovery based on physical, behavioral, and psychological criteria: active eating disorder (n =53), partially recovered (n =15; psychological criteria not met), and fully recovered (n =20; all recovery criteria met). Additionally, data were obtained from 67 female controls who had no history of an eating disorder. Self-report data indicated that controls and women fully recovered from an eating disorder scored significantly lower than partially recovered and active eating disorder groups in perceived stress, depression, and anxiety. Controls and the fully recovered group were statistically indistinguishable from each other in these domains, as were the partially recovered and active eating disorder groups, suggesting an interesting divide depending on whether psychological criteria (e.g., normative levels of weight/shape concern) were met. In contrast, controls and fully recovered and partially recovered groups all reported feeling significantly less lonely relative to those with an active eating disorder suggesting that improved perceptions of interpersonal, social support may act as a stepping stone toward more comprehensive eating disorder recovery. Future research may want to longitudinally determine if an increase in actual or perceived social support facilitates the movement toward full recovery and whether this, in turn, has
Harney, Megan B; Fitzsimmons-Craft, Ellen E; Maldonado, Christine R; Bardone-Cone, Anna M
The purpose of this study was to examine a collection of negative affect symptoms in relation to stages of eating disorder recovery. Depressive symptoms, anxiety symptoms, loneliness, and perceived stress are known to be present in individuals with eating disorders; however, less is known about the presence of such constructs throughout the recovery process. Does this negative affect fog continue to linger in individuals who have recovered from an eating disorder? Female participants seen at some point for an eating disorder at a primary care clinic were categorized into one of three groups using a stringent definition of eating disorder recovery based on physical, behavioral, and psychological criteria: active eating disorder (n=53), partially recovered (n=15; psychological criteria not met), and fully recovered (n=20; all recovery criteria met). Additionally, data were obtained from 67 female controls who had no history of an eating disorder. Self-report data indicated that controls and women fully recovered from an eating disorder scored significantly lower than partially recovered and active eating disorder groups in perceived stress, depression, and anxiety. Controls and the fully recovered group were statistically indistinguishable from each other in these domains, as were the partially recovered and active eating disorder groups, suggesting an interesting divide depending on whether psychological criteria (e.g., normative levels of weight/shape concern) were met. In contrast, controls and fully recovered and partially recovered groups all reported feeling significantly less lonely relative to those with an active eating disorder suggesting that improved perceptions of interpersonal functioning and social support may act as a stepping stone toward more comprehensive eating disorder recovery. Future research may want to longitudinally determine if an increase in actual or perceived social support facilitates the movement toward full recovery and whether this
Boone, Liesbet; Braet, Caroline; Vandereycken, Walter; Claes, Laurence
Both maladaptive schemas (MS) and perfectionism have been associated with eating pathology. However, previous research has not examined these variables simultaneously and has not studied possible mediating relationships between MS and multidimensional perfectionism for body image concerns in eating disorder (ED) patients. Eighty-eight female ED patients completed the Young Schema Questionnaire, the Frost Multidimensional Perfectionism Scale, and the Body Attitude Test. Body image concerns were found to be positively related to Personal Standards (PS) and Evaluative Concerns (EC) perfectionism and all five schema domains. PS Perfectionism was positively associated with Disconnection, Other-directedness, and Overvigilance. EC Perfectionism was positively related to Disconnection, Impaired Autonomy, Other-directedness, and Overvigilance. Moreover, EC perfectionism was found to be a significant mediator in the relationship between the schema domains Impaired Autonomy and Overvigilance and body image concerns. These findings denote the importance to address both core beliefs and perfectionism in ED treatment. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.
Sandberg, Rita Marie; Dahl, Jens K.; Vedul-Kjelsås, Einar; Engum, Bjørnar; Kulseng, Bård; Mårvik, Ronald; Eriksen, Lasse
Objective. To study health-related quality of life (HRQoL) in obese presurgery patients with binge eating disorder (BED) and with subdiagnostic binge eating disorder (SBED) compared to patients without eating disorders or SBED. Method. Participants were patients referred to St. Olavs University Hospital, Norway, for bariatric surgery. Eating Disorders in Obesity (EDO) questionnaire was used to diagnose BED and SBED. Short-Form Health Survey (SF-12) assessed health-related quality of life. Questionnaires were returned by 160 of 209 patients. The present study sample consisted of 143 patients (103 women and 40 men) as 17 patients did not complete the SF-12. Results. Patients with BED and patients with SBED both had significantly lower mental HRQoL, but not physical HRQoL, compared to patients without eating disorders. Discussion. The findings indicate that obese presurgery patients with BED, and also SBED, may have special treatment needs in regard to their mental health. PMID:23577241
Rita Marie Sandberg
Full Text Available Objective. To study health-related quality of life (HRQoL in obese presurgery patients with binge eating disorder (BED and with subdiagnostic binge eating disorder (SBED compared to patients without eating disorders or SBED. Method. Participants were patients referred to St. Olavs University Hospital, Norway, for bariatric surgery. Eating Disorders in Obesity (EDO questionnaire was used to diagnose BED and SBED. Short-Form Health Survey (SF-12 assessed health-related quality of life. Questionnaires were returned by 160 of 209 patients. The present study sample consisted of 143 patients (103 women and 40 men as 17 patients did not complete the SF-12. Results. Patients with BED and patients with SBED both had significantly lower mental HRQoL, but not physical HRQoL, compared to patients without eating disorders. Discussion. The findings indicate that obese presurgery patients with BED, and also SBED, may have special treatment needs in regard to their mental health.
Full Text Available Denise E Wilfley,1 Leslie Citrome,2 Barry K Herman3 1Department of Psychiatry, Washington University School of Medicine, St Louis, MO, 2Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY, 3Global Medical Affairs, Shire, Lexington, MA, USA Abstract: The objective of this review was to examine the evidentiary basis for binge eating disorder (BED with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5 diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included “binge eating disorder,” DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and “shape and weight concerns.” Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors’ knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive–compulsive, and impulsive disorders and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional
Nzwalo, Hipólito; Ferreira, Ligia; Peralta, Rita; Bentes, Carla
Sleep-related eating disorder (SRED) is characterised by eating episodes during the first period of the night sleep with partial loss consciousness, and amnesia. It can rarely be induced by some drugs, including zolpidem. We present a video report of a patient with a 1-year history of SRED caused by zolpidem causing important repercussions in the sleep structure and life quality. The night eating episodes ceased promptly with discontinuation of zolpidem. Upon the follow-up, the sleep structure improved and the daily consequences disappeared. As in few reported cases of zolpidem-induced SRED, our patient was suffering from the parasomnia for a long time before the diagnosis. Active exclusion of symptoms suggestive of SRED in patients under zolpidem treatment can avoid the deleterious effect of the sleep disorder.
Wilfley, Denise E; Citrome, Leslie; Herman, Barry K
The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included “binge eating disorder,” DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and “shape and weight concerns.” Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors’ knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive–compulsive, and impulsive disorders) and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes) comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional eating). Future revisions of the BED diagnostic criteria should consider the inclusion of BED subtypes, perhaps based on the overvaluation of shape/weight, and an evidence-based reassessment of severity criteria. PMID:27621631
Arditte Hall, Kimberly A; Bartlett, Brooke A; Iverson, Katherine M; Mitchell, Karen S
Eating disorders are understudied among male veterans, who may be at increased risk due to the high rates of trauma exposure and experiences of multiple traumatization in this population. This study sought to examine the associations between specific types of trauma (i.e., childhood physical abuse, adult physical assault, childhood sexual abuse, adult sexual assault, and military-related trauma) and eating disorder symptoms in a large, nationally-representative sample of trauma-exposed male veterans. Survey data were collected from N = 642 male veterans. Traumatic experiences in childhood and adulthood were assessed using the Trauma History Screen and the National Stressful Events Survey. Eating disorder symptoms were assessed with the Eating Disorder Diagnostic Scale. Analyses also controlled for age and body mass index. Multiple traumatization was associated with increased eating disorder symptoms. However, military-related trauma was the only trauma type that was uniquely associated with eating disorder symptoms when controlling for other trauma types. Examination of different types of military-related trauma indicated that this association was not driven by exposure to combat. Noncombat, military-related trauma was associated with eating disorder symptom severity in male veterans. Results highlight the need for better assessment of eating disorder symptoms in this population. © 2017 Wiley Periodicals, Inc.
Trepal, Heather C.; Boie, Ioana; Kress, Victoria E.
The authors examine eating disorders through the conceptual framework of relational cultural theory (RCT). Taking into account the importance of relationships and connection, it is suggested that RCT may be a useful lens for conceptualizing and working with people who are experiencing eating disorders. Ways that RCT can be applied to enhance…
Gupta, M A; Schork, N J
We observed a direct correlation between aging-related concerns about the appearance and Drive for Thinness (Eating Disorders Inventory [EDI]), among males (n = 71) (Pearson r = .36, p youthful looks and both Drive for Thinness (EDI) (Pearson r = .44, p important future implications in the development of eating disorders, as our society continues to place an inordinate value on youthful looks.
Kuipers, Greet S; van Loenhout, Zara; van der Ark, L Andries; Bekker, Marrie H J
To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients. We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder symptoms, depression, anxiety, personality disorders, psycho-neuroticism, autonomy problems and self-injurious behavior, using the Adult Attachment Interview, the SCID-I and II and several questionnaires. Compared with the controls, the eating disorder patients showed a higher prevalence of insecure attachment; eating disorder patients more often than controls received the AAI classification Unresolved for loss or abuse. They also had a lower level of mentalization and more autonomy problems. In the patient group eating disorder symptoms, depression, anxiety, psycho-neuroticism and autonomy problems were neither related to attachment security nor to mentalization; self-injurious behavior was associated with lesser attachment security and lower mentalization; borderline personality disorder was related to lower mentalization. In the control group no relations were found between attachment, mentalization and psychopathologic variables. Eating disorder patients' low level of mentalization suggests the usefulness of Mentalization Based Treatment techniques for eating disorder treatment, especially in case of self-injurious behavior and/or co-morbid borderline personality disorder.
Reinblatt, Shauna P.
Attention deficit/hyperactivity disorder (ADHD) is a disorder characterized by impulsivity, hyperactivity, and inattention. Binge-eating behavior is often impulsive and is the hallmark of the two eating disorders, binge-eating disorder (BED) and bulimia nervosa (BN), both of which are associated with significant health impairment. Bingeing behavior is also seen in the binge purge subtype of anorexia nervosa. Individuals with AN of the binge purge subtypes, BN and BED, have been found to exhib...
Sanftner, Jennifer L; Tantillo, Mary; Seidlitz, C S Larry
Relational theory predicts that lack of mutuality in important relationships leads to the development of psychological problems, including eating disorders. We sought to explore the association between perceived mutuality in relationships with partners and friends and eating disorders. Participants were 74 women, 35 with an eating disorder diagnosis and 39 non-psychiatric controls. The eating disorder group reported lower perceived mutuality than controls for both partners and friends. The negative aspects of perceived mutuality were particularly important in differentiating between groups. These findings held when depression was included as a covariate for friends only. Results suggest that the disconnecting aspects of relationships may play a powerful role in the phenomenology of eating disorders.
Allison, Kelly C; Spaeth, Andrea; Hopkins, Christina M
Insomnia is related to an increased risk of eating disorders, while eating disorders are related to more disrupted sleep. Insomnia is also linked to poorer treatment outcomes for eating disorders. However, over the last decade, studies examining sleep and eating disorders have relied on surveys, with no objective measures of sleep for anorexia nervosa or bulimia nervosa, and only actigraphy data for binge eating disorder. Sleep disturbance is better defined for night eating syndrome, where sleep efficiency is reduced and melatonin release is delayed. Studies that include objectively measured sleep and metabolic parameters combined with psychiatric comorbidity data would help identify under what circumstances eating disorders and sleep disturbance produce an additive effect for symptom severity and for whom poor sleep would increase risk for an eating disorder. Cognitive behavior therapy for insomnia may be a helpful addition to treatment of those with both eating disorder and insomnia.
Full Text Available Binge Eating Disorder, characterized by frequent and persistent overeating episodes that are accompanied by feeling of loss of control over eating without regular compensatory behaviors and was identified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition as a new eating disorder category. Binge Eating Disorder is the most common eating disorder among adults. Binge Eating Disorder is associated with significant morbidity, including medical complications related to obesity, eating disorder psychopathology, psychiatric comorbidity; reduced quality of life, and impaired social functioning. Current treatments of Binge Eating Disorder include pharmacotherapy, psychotherapy and bariatric surgery. In this review, the definition, epidemiology, etiology, clinical features, and also mainly treatment of Binge Eating Disorder are discussed.
Nielsen, Søren; Møller-Madsen, S.; Isager, Torben
Ten eating disorder (ED) populations were reviewed using the standardized mortality ratio (SMR) presenting new evidence for several studies. In eight of the ten samples, strong evidence (in one sample weak evidence and in one sample no evidence) supports an hypothesis of elevated SMR. We found...
Nielsen, Søren; Møller-Madsen, S.; Isager, Torben
Ten eating disorder (ED) populations were reviewed using the standardized mortality ratio (SMR) presenting new evidence for several studies. In eight of the ten samples, strong evidence (in one sample weak evidence and in one sample no evidence) supports an hypothesis of elevated SMR. We found...
Brion, Agnès; Flamand, Mathilde; Oudiette, Delphine; Voillery, Dorothée; Golmard, Jean-Louis; Arnulf, Isabelle
Sleep-related eating disorder (SRED) may have some common clinical features with sleepwalking and with eating behavior disorders. The objective of this study was to compare clinical, sleep, and eating behavior measures in patients with SRED vs. sleepwalkers and controls. Overall, 15 patients with SRED, 21 sleepwalkers, and 20 age- and sex-matched healthy volunteers underwent interviews, completed sleep, anxiety, depression, and eating behavior scales, and had a night-time videopolysomnography. Patients with SRED were mainly women, had disease onset in adulthood, suffered nightly episodes and insomnia, and had more frequent eating problems in childhood and higher current anorexia scores than sleepwalkers and controls. Unlike controls, they shared several commonalities with sleepwalkers, including a high frequency (66%) of past or current sleepwalking, a similar timing of parasomnia episodes during the first half of the night, numerous arousals from stage N3, and a similarly altered level of daytime sleepiness and anxiety, but higher awareness during parasomnia episodes. Conversely, only 10% of sleepwalkers ate during their sleepwalking episodes. On videopolysomnography, the eating episodes occurred mostly within 1min after awakening from stage N2 (n=9) or stage N3 (n=6). The frequencies of restless legs syndrome, periodic leg movements, and sleep apnea were similar across the three groups. Patients with SRED share several clinical commonalities with sleepwalkers (although their level of awareness is higher) plus former or current eating behavior problems. It suggests that they have specialized a former sleepwalking behavior toward sleep-related eating because they are more vulnerable to eating behavior problems during the daytime. Copyright © 2012 Elsevier B.V. All rights reserved.
Grubb, H J; Sellers, M I; Waligroski, K
To test hypotheses that women suffering from some form of eating disorder would experience lower self-esteem and higher depression and that women with lower self-esteem and greater depression would rate their attractiveness lower and see themselves as heavier than less depressed individuals, 42 college undergraduate women were individually administered the Eating Disorders Inventory, Beck Depression Inventory, Coopersmith Self-esteem Inventory, and a Body Image/Attractiveness Perception Scale. A Pearson correlation indicated a substantial relation between scores on depression and scores on eating disorders, but nonsignificant values between self-esteem scores and scores on either eating disorders or on depression. Depression scores correlated significantly with rated body size, but not attractiveness, while self-esteem scores were significantly correlated with rated attractiveness, not body size. These results contradict literature on the relation between self-esteem and depression. Directions for additional research are discussed.
Simpson, Courtney C; Mazzeo, Suzanne E
A pattern of disordered eating involving a pathological fixation with healthy food consumption, labeled orthorexia nervosa (ON), has recently generated attention; however, research has not yet investigated perceptions of ON-related behaviors. This study examined potential stigmatization of ON, compared with DSM-5 ED diagnoses. Participants (N = 505) were randomly assigned to read a vignette depicting a woman with anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), or ON. They then answered questions about the individual depicted in the vignette. A series of MANOVAs investigated whether opinions and beliefs about the person depicted varied as a function of the disorder described in the vignette. Individuals with ON were perceived as less likely to "improve with treatment" than individuals with BN, and less likely to "pull themselves together," than individuals with BED. Individuals with ON and AN were viewed as "hard[er] to talk to" and more of a "danger to others" compared with individuals with BED. ON was viewed as less distressing, less likely to evoke sympathy, and more acceptable than the other disorders. Finally, "poor living choices" were perceived as contributing more substantially to ON. Participants' attributions of various personality characteristics did not differ based on ED diagnosis. Results suggest that ON is viewed as less severe, more desirable, and more often the result of personal life choices. However, findings also imply that ON is associated with stigma, similar to DSM-5 EDs. These negative attitudes might reinforce ON behaviors, and limit awareness of their potential complications. © 2017 Wiley Periodicals, Inc.
Hussain, Yusuf; Krishnamurthy, Sairam
Binge eating disorder (BED) is a stress-related disorder characterized by acute episodes of excessive food intake. Piracetam, a nootropic agent has been reported to show several other neuropharmacological properties. The present study, evaluated the pharmacological effect of piracetam (200 mg/kg i.p.) on BED in female rats, induced by free access to palatable cookies for 2 h on alternate days. BED was confirmed by an increase in binge eating behavior and weight gain. BED leads to anxiety, cognitive and memory deficits, as evaluated by EPM (Elevated plus maze), OFT (open field test), and Y-maze tests. Increased levels of plasma corticosterone (CORT), glutamate in nucleus accumbens (NAC), hypothalamus (HYP) and prefrontal cortex (PFC) indicate stress and excitotoxicity. Moreover, it was observed that the levels of dopamine were higher in NAC and PFC, and less in HYP which may be responsible for motivational behavior for palatable feeding and cognitive deficits. More surprisingly, feeding behaviour regulating hormones namelyleptin was increased and ghrelin level was decreased in BED. Further, level of acetylcholine which regulates cognitive behaviour was compromised in BED. Piracetam significantly decreased binge eating behavior and associated body weight and regulated the levels of concerned neurotransmitters in respective regions. However, piracetam did not alter normal feeding behavior in the fast-refed model. Further, piracetam showed brain region-specific decrease in vascular endothelial growth factor expression. Piracetam showed anxiolytic activity and also alleviated cognitive deficit observed in BED. Hence, preclinical evidence indicates the potential use of piracetam for the treatment of BED. Copyright © 2018 Elsevier Inc. All rights reserved.
Full Text Available Background The aim of the article was to present the results of the author’s own study that sought relationships between having experienced psychological trauma and the psychological characteristics of people with eating disorders. The basic research question was the following: To what degree are the traumatic events experienced by females with various types of eating disorders related to these females’ psychological characteristics? Participants and procedure The sample comprised 120 females with eating disorders: 30 females aged between 20 and 26 diagnosed with bulimia nervosa, 31 females diagnosed with binge-eating disorder and 59 females aged between 20 and 26 diagnosed with anorexia nervosa. The research was carried out in the years 2007-2012 in outpatient clinics treating neuroses and eating disorders and mental health outpatient clinics in Poland. The study employed a clinical and psychometric (i.e., questionnaires for measuring psychological characteristics approach. Results Statistical analysis confirmed the existence of significant differences between the females with eating disorders who have experienced relational trauma(s in their lives (particularly in their childhood and adolescence and those who did not reveal such experience. The females with anorexia and bulimia who have also experienced psychological, physical or sexual violence revealed a significantly different, higher level of bulimic thinking and tendencies for excessively uncontrolled, impulsive behaviors towards food and nutrition (i.e., vomit-provoking and other forms of body purgation, e.g. using purgative drugs and others than did females with no relational trauma experience. Conclusions The frequency of relational trauma occurrence was significantly higher for females with bulimia and bulimic anorexia. For females with restrictive anorexia and binge-eating disorder, no significantly frequent occurrence of trauma was observed. Diagnosing the occurrence of
Sanftner, Jennifer L
This study examined health-related quality of life in relation to psychosocial variables associated with eating disorders. A sample of 266 women and 114 men from a Midwestern university completed questionnaires asking about both generic and eating disorder-specific health-related quality of life, as well as body dissatisfaction, objectified body consciousness, internalization of sociocultural ideals, and restrained eating. Results revealed that women reported significantly higher levels of psychosocial risk variables than men. In addition, for women, all but one of the psychosocial risk variables was found to be associated with lower quality of life. Gender moderated the relationship between quality of life and objectified body consciousness, but not the other psychosocial risk variables. Finally, comparisons between a generic and an eating disorder-specific quality of life scale revealed that the eating disorder-specific scale had higher sensitivity for use in a college student population. These results suggest that women who are at higher risk for developing an eating disorder suffer from lower quality of life, and that eating disorder-specific quality of life scales are useful in understanding women and men in a general population. Copyright © 2011 Elsevier Ltd. All rights reserved.
Wilfley, Denise E; Citrome, Leslie; Herman, Barry K
Denise E Wilfley,1 Leslie Citrome,2 Barry K Herman3 1Department of Psychiatry, Washington University School of Medicine, St Louis, MO, 2Department of Psychiatry & Behavioral Sciences, New York Medical College, Valhalla, NY, 3Global Medical Affairs, Shire, Lexington, MA, USA Abstract: The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (D...
Fitzsimmons-Craft, Ellen E; Bardone-Cone, Anna M; Kelly, Kathleen A
In Western society, the feminine body has been positioned as an object to be looked at and sexually gazed upon; thus, females often learn to view themselves as objects to be observed (i.e., objectified body consciousness (OBC)). This study examined the relation between OBC and eating disorder recovery by comparing its components across non-eating disorder controls, fully recovered, partially recovered, and active eating disorder cases. Results revealed that non-eating disorder controls and fully recovered individuals had similarly low levels of two components of OBC, body surveillance and body shame. Partially recovered individuals looked more similar to those with an active eating disorder on these constructs. The third component of OBC, control beliefs, and a conceptually similar construct, weight/shape self-efficacy, did not differ across groups. Results provide support for the importance of measuring aspects of self-objectification, particularly body surveillance and body shame, across the course of an eating disorder. Copyright Â© 2011 Elsevier Ltd. All rights reserved.
Nielsen, Søren; Møller-Madsen, S.; Isager, Torben
Ten eating disorder (ED) populations were reviewed using the standardized mortality ratio (SMR) presenting new evidence for several studies. In eight of the ten samples, strong evidence (in one sample weak evidence and in one sample no evidence) supports an hypothesis of elevated SMR. We found...... strong evidence for an increase in SMR for anorexia nervosa (AN), whereas no firm conclusions could be drawn for bulimia nervosa (BN). Bias caused by loss to follow-up was quantified and found non-negligable in some samples (possible increase in SMR from 25% to 240%). We did not find a significant effect...
Nielsen, Søren; Møller-Madsen, S.; Isager, Torben
Ten eating disorder (ED) populations were reviewed using the standardized mortality ratio (SMR) presenting new evidence for several studies. In eight of the ten samples, strong evidence (in one sample weak evidence and in one sample no evidence) supports an hypothesis of elevated SMR. We found...... strong evidence for an increase in SMR for anorexia nervosa (AN), whereas no firm conclusions could be drawn for bulimia nervosa (BN). Bias caused by loss to follow-up was quantified and found non-negligable in some samples (possible increase in SMR from 25% to 240%). We did not find a significant effect...
Full Text Available Ignacio Jáuregui-Lobera1,21Behavioral Sciences Institute, 2Pablo de Olavide University, Seville, SpainAbstract: Clinical applications of electroencephalography (EEG are used with different objectives, EEG being a noninvasive and painless procedure. In respect of eating disorders, in the 1950s a new line of study about the neurological bases of anorexia nervosa was started and has since been developed. The purpose of this review is to update the existing literature data on the main findings in respect of EEG in eating disorders by means of a search conducted in PubMed. Despite the fact that weight gain tends to normalize some brain dysfunctions assessed by means of EEG, the specific effect of gaining weight remains controversial. Different studies have reported that cortical dysfunctions can be found in patients with anorexia nervosa even after weight gain, whereas others have reported a normalization of EEG in respect of the initial reduced alpha/increased beta power in those patients with refeeding. Findings of studies that have analyzed the possible relationship between eating disorders and depression, based on sleep EEG disturbances, do not support the idea of eating disorders as a variant of depression or affective disorders. Some EEG findings are very consistent with previous neuroimaging results on patients with anorexia nervosa, reporting neural disturbances in response to stimuli that are relevant to the pathology (eg, stimuli like food exposure, different emotional situations, or body images.Keywords: electroencephalography, event-related potentials, sleep, depression, refeeding, weight gain
Pohjolainen, Veera; Koponen, Salla; Räsänen, Pirjo; Roine, Risto P; Sintonen, Harri; Karlsson, Hasse
There is limited evidence on the long-term development of health-related quality of life (HRQoL) in eating disorders and its relation to eating disorder symptoms. Our objective was to measure long-term change in the HRQoL of eating disorder patients and compare it to normal population. Fifty-four bulimia nervosa (BN) and forty-seven anorexia nervosa (AN) patients (ICD-10 diagnosis) entering treatment completed the 15D HRQoL questionnaire and the Eating Disorder Inventory (EDI) before and approximately 8 years after the start of treatment. Baseline HRQoL was severely impaired in the patients. During follow-up, mean HRQoL, body mass index (BMI) and EDI improved statistically significantly in both groups. BMI of AN patients reached normal values, but HRQoL was still severely impaired in both AN and BN compared to general population. The long-term HRQoL after treatment continues to improve, but is still after 8 years poor. Eating disorders are very serious conditions with long-lasting impact on quality of life even after symptom remission.
Eating disorders are serious behavior problems. They can include severe overeating or not consuming enough food to stay ... concern about your shape or weight. Types of eating disorders include Anorexia nervosa, in which you become too ...
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Full Text Available In this paper, we present two carefully documented cases of patients with sleep-related eating disorder (SRED, a parasomnia which is characterized by involuntary compulsive eating during the night and whose pathophysiology is not known. Using video-polysomnography and psychometric examination, we found that both patients present elevated novelty seeking and increased reward sensitivity on reward-related questionnaires. In light of new evidence on the mesolimbic dopaminergic implication in compulsive eating disorders, our findings suggest a role of an active reward system during sleep in the manifestation of SRED.
Silva, Wanderson Roberto da; Santana, Moema de Souza; Maroco, João; Maloa, Benvindo Felismino Samuel; Campos, Juliana Alvares Duarte Bonini
Body weight concerns are common among individuals with eating disorders, and this construct can be assessed using psychometric instruments. The Weight Concerns Scale (WCS) is commonly used to assess body weight concerns. To evaluate the psychometric properties of the WCS with Brazilian, Portuguese, and Mozambican female college students; to estimate body weight concerns; and to identify factors related to eating disorders. Confirmatory factor analysis was performed. Factorial, convergent, concurrent, and divergent validity, as well as reliability, were assessed. Cross-national invariance was tested by means of multigroup analysis. Structural models were tested using the WCS as the dependent variable, while demographic and academic variables and body mass index were used as independent variables. Logistic models were tested to estimate the likelihood of eating disorders being developed in specific groups. Participants were 2,068 female students. The psychometric properties of the WCS were adequate for the Portuguese sample; however, for the Brazilian and Mozambican samples, it was necessary to correlate the errors of two items to improve model fit. The WCS did not show cross-national invariance. The variables "thoughts about dropping out of college," "medication use because of studies," "medication and supplements use for body change," "body mass index," "socioeconomic status," "age," and "performance in course" were significant predictors of body weight concerns. Overall, 24.4% (95% confidence interval = 22.9-26.7) of the students were likely to develop eating disorders. Students under 21 years old, who use medication and supplements for body change, and who were classified as overweight/obese have increased likelihood of developing eating disorders. The WCS showed good psychometric properties with Brazilian, Portuguese, and Mozambican students; however, it did not show cross-national invariance. We identified important aspects for investigating body weight
Linna, Milla S; Raevuori, Anu; Haukka, Jari; Suvisaari, Jaana M; Suokas, Jaana T; Gissler, Mika
Eating disorders are common psychiatric disorders in women at childbearing age. Previous research suggests that eating disorders are associated with fertility problems, unplanned pregnancies, and increased risk of induced abortions and miscarriages. The purpose of this study was to assess how eating disorders are related to reproductive health outcomes in a representative patient population. Female patients (N = 2,257) treated at the eating disorder clinic of Helsinki University Central Hospital during 1995-2010 were compared with matched controls identified from the Central Population Register (N = 9,028). Patients had been diagnosed (ICD-10) with anorexia nervosa (AN), atypical AN, bulimia nervosa (BN), atypical BN, or binge eating disorder (BED, according to DSM-IV research criteria). Register-based data on number of children, pregnancies, childbirths, induced abortions, miscarriages, and infertility treatments were used to measure reproductive health outcomes. Patients were more likely to be childless than controls [odds ratio (OR) 1.86; 95% confidence interval (CI) 1.62-2.13, p health outcomes are compromised in women with a history of eating disorders across all eating disorder types. Our findings emphasize the importance of reproductive health counseling and monitoring among women with eating disorders. Copyright © 2013 Wiley Periodicals, Inc.
Miyake, Yoshie; Okamoto, Yuri; Jinnin, Ran; Shishida, Kazuhiro; Okamoto, Yasumasa
Eating disorders are characterized by aberrant patterns of eating behavior, including such symptoms as extreme restriction of food intake or binge eating, and severe disturbances in the perception of body shape and weight, as well as a drive for thinness and obsessive fears of becoming fat. Eating disorder is an important cause for physical and psychosocial morbidity in young women. Patients with eating disorders have a deficit in the cognitive process and functional abnormalities in the brain system. Recently, brain-imaging techniques have been used to identify specific brain areas that function abnormally in patients with eating disorders. We have discussed the clinical and cognitive aspects of eating disorders and summarized neuroimaging studies of eating disorders.
Gucciardi, Enza; Celasun, Nalan; Ahmad, Farah; Stewart, Donna E
Abstract Health Issue Eating disorders are an increasing public health problem among young women. Anorexia and bulimia may give rise to serious physical conditions such as hypothermia, hypotension, electrolyte imbalance, endocrine disorders, and kidney failure. Key Issues Eating disorders are primarily a problem among women. In Ontario in 1995, over 90% of reported hospitalized cases of anorexia and bulimia were women. In addition to eating disorders, preoccupation with weight, body image and...
Forghieri, M; Monzani, D; Mackinnon, A; Ferrari, S; Gherpelli, C; Galeazzi, G M
Human postural control is dependent on the central integration of vestibular, visual and proprioceptive inputs. Psychological states can affect balance control: anxiety, in particular, has been shown to influence balance mediated by visual stimuli. We hypothesized that patients with eating disorders would show postural destabilization when exposed to their image in a mirror and to the image of a fashion model representing their body ideal in comparison to body neutral stimuli. Seventeen females patients attending a day centre for the treatment of eating disorders were administered psychometric measures of body dissatisfaction, anxiety, depression and underwent posturographic measures with their eyes closed, open, watching a neutral stimulus, while exposed to a full length mirror and to an image of a fashion model corresponding to their body image. Results were compared to those obtained by eighteen healthy subjects. Eating disordered patients showed higher levels of body dissatisfaction and higher postural destabilization than controls, but this was limited to the conditions in which they were exposed to their mirror image or a fashion model image. Postural destabilization under these conditions correlated with measures of body dissatisfaction. In eating disordered patients, body related stimuli seem to act as phobic stimuli in the posturographic paradigm used. If confirmed, this has the potential to be developed for diagnostic and therapeutic purposes. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Wisting, Line; Bang, Lasse; Skrivarhaug, Torild; Dahl-Jørgensen, Knut; Rø, Øyvind
To investigate correlates of eating disorder psychopathology in adolescent males and females with type 1 diabetes. A total of 105 adolescents with type 1 diabetes (42% males), aged 12-20 years, were recruited from the Norwegian Childhood Diabetes Registry in this population-based study. All participants were interviewed with the Child Eating Disorder Examination. Additionally, the Brief Illness Perception Questionnaire, the Adolescent Coping Orientation for Problem Experiences and the Beliefs about Medicines Questionnaire were administered to assess health-related functioning. Clinical data were obtained from the Norwegian Childhood Diabetes Registry. Significant gender differences were demonstrated in the pattern of correlates of eating disorder pathology. Among females, eating disorder psychopathology was significantly associated with body mass index adjusted for age and gender, age, insulin restriction, coping, illness perceptions, and perceptions of insulin concern. In a regression model, age, illness perceptions, and insulin restriction remained significantly associated with eating disorder psychopathology, explaining 48% of the variance. None of the variables were associated with eating disorder psychopathology among males. Greater clinical awareness of illness perceptions, attitudes toward insulin, and insulin restriction may potentially decrease the risk of developing eating disorders among female adolescents with type 1 diabetes, and the subsequent increased morbidity and mortality associated with comorbid type 1 diabetes and eating disorders.
Full Text Available To investigate correlates of eating disorder psychopathology in adolescent males and females with type 1 diabetes.A total of 105 adolescents with type 1 diabetes (42% males, aged 12-20 years, were recruited from the Norwegian Childhood Diabetes Registry in this population-based study. All participants were interviewed with the Child Eating Disorder Examination. Additionally, the Brief Illness Perception Questionnaire, the Adolescent Coping Orientation for Problem Experiences and the Beliefs about Medicines Questionnaire were administered to assess health-related functioning. Clinical data were obtained from the Norwegian Childhood Diabetes Registry.Significant gender differences were demonstrated in the pattern of correlates of eating disorder pathology. Among females, eating disorder psychopathology was significantly associated with body mass index adjusted for age and gender, age, insulin restriction, coping, illness perceptions, and perceptions of insulin concern. In a regression model, age, illness perceptions, and insulin restriction remained significantly associated with eating disorder psychopathology, explaining 48% of the variance. None of the variables were associated with eating disorder psychopathology among males.Greater clinical awareness of illness perceptions, attitudes toward insulin, and insulin restriction may potentially decrease the risk of developing eating disorders among female adolescents with type 1 diabetes, and the subsequent increased morbidity and mortality associated with comorbid type 1 diabetes and eating disorders.
Wisting, Line; Bang, Lasse; Skrivarhaug, Torild; Dahl-Jørgensen, Knut; Rø, Øyvind
Objective To investigate correlates of eating disorder psychopathology in adolescent males and females with type 1 diabetes. Method A total of 105 adolescents with type 1 diabetes (42% males), aged 12–20 years, were recruited from the Norwegian Childhood Diabetes Registry in this population-based study. All participants were interviewed with the Child Eating Disorder Examination. Additionally, the Brief Illness Perception Questionnaire, the Adolescent Coping Orientation for Problem Experiences and the Beliefs about Medicines Questionnaire were administered to assess health-related functioning. Clinical data were obtained from the Norwegian Childhood Diabetes Registry. Results Significant gender differences were demonstrated in the pattern of correlates of eating disorder pathology. Among females, eating disorder psychopathology was significantly associated with body mass index adjusted for age and gender, age, insulin restriction, coping, illness perceptions, and perceptions of insulin concern. In a regression model, age, illness perceptions, and insulin restriction remained significantly associated with eating disorder psychopathology, explaining 48% of the variance. None of the variables were associated with eating disorder psychopathology among males. Discussion Greater clinical awareness of illness perceptions, attitudes toward insulin, and insulin restriction may potentially decrease the risk of developing eating disorders among female adolescents with type 1 diabetes, and the subsequent increased morbidity and mortality associated with comorbid type 1 diabetes and eating disorders. PMID:26529593
Ray, Shannon L.
Research indicates that the primary onset of eating disorders occurs in adolescence and that there is a growing prevalence of adolescent males with eating disorders. This article describes the eating disorders of anorexia nervosa and bulimia nervosa as they relate to adolescent males. Diagnostic criteria, at-risk groups, and implications for…
Fiorillo, Andrea; Sampogna, Gaia; Luciano, Mario; Del Vecchio, Valeria; Volpe, Umberto; Monteleone, Alessio Maria; Bruni, Antonella; Segura-Garcìa, Cristina; Catapano, Francesco; Monteleone, Palmiero; Maj, Mario
This paper aims to: (1) describe coping strategies in relatives of patients with eating disorders (EDs); (2) analyze coping strategies according to the different EDs; (3) identify correlations between patients' clinical characteristics, relatives' socio-demographic characteristics and coping strategies. Patients and their relatives consecutively attending three outpatient units for EDs at the Universities of Naples SUN, Salerno and Catanzaro were recruited. Coping strategies were assessed through the Family Coping Questionnaire for Eating Disorders (FCQ-ED). It consists of 32 items, grouped into two factors: problem-oriented ("seek for information", "positive communication") and emotion-focused ("avoidance," "collusion," "coercion") strategies, plus one item on seeking for spiritual help. Seventy-two patients and 127 relatives were recruited. The most frequently reported coping strategies by relatives were seeking for information, positive communication, seeking for spiritual help; the first two coping strategies were positively correlated with the level of education of both patients and relatives. Mothers reported avoidance less frequently than other relatives. Relatives of patients with BN reported collusion and coercion more frequently compared to relatives of patients with AN. This report represents an initial attempt to understand the complex relationship among clinical, social and personal variables involved in the development of coping strategies. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:587-592). © 2016 Wiley Periodicals, Inc.
This study examined the relationship between plasma cholesterol and circulating triiodothyronine and oestradiol in 561 adolescent girls aged 11-17 with eating disorders. Plasma total cholesterol, high-density lipoprotein cholesterol, serum triodothyronine and oestradiol were measured at assessment, and historical weight data were obtained from growth charts provided by the school health services. Cholesterol levels were related to weight change, menstrual status and serum hormones. Plasma total cholesterol levels of >5.0 mmol/L were found in 38% of the 77 girls who were premenarcheal, 32% of the 199 with secondary amenorrhoea and 17% of those who were still menstruating. These cholesterol levels were inversely related to serum oestradiol and triiodothyronine concentrations, but not weight change, in amenorrhoic girls and were positively related to body mass index and inversely related to weight loss and serum triiodothyronine in girls who were still menstruating. Increased plasma total cholesterol was related to amenorrhoea in adolescent girls with eating disorders and weight loss. Oestrogens appeared to mediate the effect of starvation on cholesterol, most effectively in premenarcheal girls. Re-establishing menstruation is an important goal in the treatment of eating disorders, to avoid dyslipidaemia and the risk of future cardiovascular disease. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.
Perpiñá, Conxa; Roncero, María; Belloch, Amparo; Sánchez-Reales, Sergio
The aims of this study were, first, to examine the structure and validity of the Eating-related Intrusive Thoughts Inventory (INPIAS), a self-report questionnaire designed to assess eating disorders related to intrusive thoughts (EDITs), and second, to explore the existence of a continuum ranging from normal to abnormal thought intrusions related to eating, weight, and shape. Participants were 574 (408 women) nonclinical community individuals. Analyses revealed that EDITs can be clustered into three sets: appearance-dieting, need to exercise, and thoughts-impulses related to eating disorders. EDITs' consequences showed a two-factor structure: emotional consequences/personal meaning and thought-action fusion responsibility; and four factors of strategies: "anxiety," suppression, obsessive-compulsive rituals, and distraction. The sample was then divided according to reported restrained eating. The High dietary restraint group reported a higher frequency of EDITs, whereas differences in the other factors were mediated by depression, anxiety, and obsessionality. The results suggest that eating disorder-related cognitions are experienced by nonclinical individuals, and distributed on a continuum.
Introduction Somnambulism or sleepwalking is a disorder of arousal from non-rapid eye movement sleep. The prevalence of sleep-related eating disorder has been found to be approximately between 1% and 5% among adults. Many cases of medication-related somnambulism and sleep-related eating disorder-like behavior have been reported in the literature. Quetiapine, an atypical antipsychotic medication, has been associated with somnambulism but has not yet been reported to be associated with sleep-related eating disorder. Case presentation Case 1 is a 51-year-old obese African American male veteran with a body mass index of 34.11kg/m2 and severe sleep apnea who has taken 150mg of quetiapine at bedtime for more than one year for depression. He developed sleepwalking three to four nights per week which resolved after stopping quetiapine while being compliant with bi-level positive pressure ventilation therapy. At one year follow-up, his body mass index was 32.57kg/m2. Case 2 is a 50-year-old African American female veteran with a body mass index of 30.5kg/m2 and mild sleep apnea who has taken 200mg of quetiapine daily for more than one year for depression. She was witnessed to sleepwalk three nights per week which resolved after discontinuing quetiapine while being treated with continuous positive airway pressure. At three months follow-up, her body mass index was 29.1kg/m2. Conclusion These cases illustrate that quetiapine may precipitate complex motor behavior including sleep-related eating disorder and somnambulism in susceptible patients. Atypical antipsychotics are commonly used in psychiatric and primary care practice, which means the population at risk of developing parasomnia may often go unrecognized. It is important to recognize this potential adverse effect of quetiapine and, to prevent injury and worsening obesity, discuss this with the patients who are prescribed these medications. PMID:23130910
Kinzl, Johann F; Biebl, Wilfried
The various eating disorders, anorexia nervosa, bulimia nervosa, and binge-eating disorder, are characterized by severe disturbances in eating behavior and are seen as typical "psychosomatic disorders". The subdivision of anorexia nervosa into two subtypes, namely "anorexia nervosa restricting type" and "anorexia nervosa bulimic type" has proved to be very good. It is to be assumed that eating disorders are not a homogeneous group, and that the various subtypes of eating disorders are also heterogeneous at several levels. Co-morbid psychiatric disorders, especially affective disorders, anxiety disorders, substance-related disorders, and personality disorders, are often found in eating- disordered patients. Many anorectics of the restrictive type and orthorectics show co-morbid psychiatric disorders such as anxiety disorders, obsessive-compulsive disorders, and avoidant or obsessive-compulsive personality disorders, while a co-morbidity of affective disorders, addiction, personality disorders, especially multi-impulsivity and borderline personality disorder, is frequently found in anorectics of bulimic type, bulimics, and binge eaters. Addictive behavior manifests itself in permanent preoccupation with food and eating, withdrawal symptoms, continuation of disturbed eating behavior in spite of negative consequences, loss of control, and frequent relapse. There are some indications that there is a basic psychological disturbance common to eating disorders, especially bulimia nervosa, and to substance-related disorders, namely a personality disorder with an emotional instability and multi-impulsivity. The possible associations between eating disorders and mental disorders, particularly addictions, will be discussed.
The aim of this bachelor thesis is to create an eating disorder prevention program. The thesis particularly focuses on the eating disorder problems during adolescence and early adulthood along with the explanation and specification of basic terms, history and cause of the disorder. A strong emphasis is placed on the possibilities of the prevention. A qualitative research was carried out within the scope of this thesis and it brought useful data about the students and their knowledge of the ea...
Kontić Olga; Vasiljević Nadja; Trišović Marija; Jorga Jagoda; Lakić Aneta; Jašović-Gašić Miroslava
Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis...
Kass, Andrea E; Wang, Annie Z; Kolko, Rachel P; Holland, Jodi C; Altman, Myra; Trockel, Mickey; Taylor, C Barr; Wilfley, Denise E
Discussions about weight between medical professionals and young adults may increase risk of eating disorders (EDs). Clarifying the relation between screening for overweight and ED risk is needed. 548 college-age women were classified as at-risk (n=441) or with an ED (n=107), and were assessed for disordered eating attitudes, behaviors, and relevant history, including, "Has a doctor, nurse, or other medical professional ever told you that you were overweight?" Regression analyses were used to evaluate the relations between being identified as overweight and current disordered eating behaviors, attitudes, and ED diagnosis, without and with covariates (history of weight-related teasing, history of an ED, family history of being identified as overweight, and current body mass index). 146 (26.6%) women reported being previously identified as overweight by a medical professional. There was no relation between being previously identified as overweight and having an ED. Those identified as overweight were more likely to have weight/shape concerns above a high-risk cutoff, but showed no difference in dietary restraint, binge eating, purging behaviors, or excessive exercise compared to those not identified. Being previously identified as overweight by a medical professional was associated with increased weight/shape concerns but not with current disordered eating behaviors or ED status. Minimizing the potential negative effects of overweight screening on weight and shape concerns by providing patients with strategies to increase healthy lifestyle behaviors and long-term support for healthy weight loss goals may have a positive impact on reducing the public health problem of overweight and obesity. Copyright © 2014 Elsevier Ltd. All rights reserved.
Deniz Tuncel; Fatma Özlem Orhan
Hunger is an awakening related biological impulse. The relationship between hunger and sleep is moderated by the control of homeostatic and circadian rhytms of the body. Abnormal eating behavior during sleep period could result from different causes. Abnormal eating during the main sleep period has been categorized as either night eating syndrome or sleep related eating disorder. Night eating syndrome (NES) is an eating disorder characterised by the clinical features of morning anorexia, even...
Kuipers, G.S.; van Loenhout, Z.; van der Ark, L.A.; Bekker, M.H.J.
Objective: To investigate the relationships of attachment security and mentalization with core and co-morbid symptoms in eating disorder patients. Method: We compared 51 eating disorder patients at the start of intensive treatment and 20 healthy controls on attachment, mentalization, eating disorder
Naeimi, Alireza Farsad; Haghighian, Hossein Khadem; Gargari, Bahram Pourghassem; Alizadeh, Mohammad; Rouzitalab, Tohid
Eating disorders are rapidly increasing in young adults. But, a few studies have examined the risk of eating disorders and body image in university students of non-Western societies. The current study aimed to assess eating disorders risk in relation to body image and self-esteem among Iranian university students. The participants were 430 students from Tabriz, between April and May 2015. The 26-item Eating Attitude Test (EAT-26), Multidimensional Body-Self Relations Questionnaire (MBSRQ) and Rosenberg's Self-Esteem Questionnaires were used. EAT-26 score of 20 or more was considered as eating disorders risk cutoff. Majority of the students (68 %) were females. The overall eating disorders risk was 9.5 % (7.5 and 10.5 % in men and women, respectively). Further, the prevalence of poor body image and low self-esteem was 34.2 and 16 %, respectively. Neither of the gender differences was statistically significant (p > 0.05). In simple logistic regression, there were significant associations between self-esteem, body image, parental education and eating disorders risk (p Body Mass Index (BMI) and marital status, only self-esteem (OR = 0.37, 95 % = 0.16-0.87) and mother's education level (OR = 2.78, 95 % = 1.30-5.93) were predictors of eating disorders risk. The findings revealed that low self-esteem and mother's higher education may increase eating disorders risk and the predictive role of body image possibly is by other mediators such as self-esteem. This warrants awareness improvement and developing appropriate interventions targeting self-esteem and self-respect of students.
Baiano, Monica; Salvo, Pierandrea; Righetti, Pierluigi; Cereser, Lucia; Baldissera, Erika; Camponogara, Ilenia; Balestrieri, Matteo
People with eating disorders (ED) often report poor health-related quality of life (HRQoL), which is explicitly correlated to illness' severity and its effects on cognitive performance. We aimed to analyze health-related quality of life (HRQoL) in subgroups of eating disorder (ED) patients by using the brief version of WHOQoL questionnaire (WHOQoL-BREF) before treatment administration. Moreover, in order to compare our findings with other published data, we carried out a comprehensive review of the literature on HRQoL in ED patients. Our review was carried out by means of an accurate data mining of PsychInfo and Medline databases and other available sources. In our cross-sectional study, eighty female ED patients (26 with bulimia nervosa, 33 with anorexia nervosa, 7 with binge eating disorder and 14 with ED not otherwise specified) completed the WHOQoL-BREF. HRQoL scores were compared among ED subgroups and clinical information (presence of previous contacts, length of illness, psychiatric comorbidity) was considered in the analysis. Our review shows that with few exceptions ED patients have a poorer HRQoL than the healthy population of control and sometimes the mental component of HRQoL is the most involved dimension. Moreover, there are no differences in the HRQoL among ED groups, even if AN patients in some studies have a lower HRQoL scores. Furthermore, BED patients have a poorer HRQoL than obese patients who do not have binge episodes. Finally, all treatments were positively correlated with an improvement on general and specific QoL dimensions. In our sample, ED subgroups differed only for Psychological Health HRQoL scores (F = 4.072, df = 3; p = 0.01). No differences were found between inpatients and outpatients, treatment naïve and previously treated patients and patients with or without psychiatric comorbidity. Moreover, HRQoL scores were not correlated to length of illness within each ED subgroup. The analysis of the literature adds some
Background People with eating disorders (ED) often report poor health-related quality of life (HRQoL), which is explicitly correlated to illness’ severity and its effects on cognitive performance. We aimed to analyze health-related quality of life (HRQoL) in subgroups of eating disorder (ED) patients by using the brief version of WHOQoL questionnaire (WHOQoL-BREF) before treatment administration. Moreover, in order to compare our findings with other published data, we carried out a comprehensive review of the literature on HRQoL in ED patients. Methods Our review was carried out by means of an accurate data mining of PsychInfo and Medline databases and other available sources. In our cross-sectional study, eighty female ED patients (26 with bulimia nervosa, 33 with anorexia nervosa, 7 with binge eating disorder and 14 with ED not otherwise specified) completed the WHOQoL-BREF. HRQoL scores were compared among ED subgroups and clinical information (presence of previous contacts, length of illness, psychiatric comorbidity) was considered in the analysis. Results Our review shows that with few exceptions ED patients have a poorer HRQoL than the healthy population of control and sometimes the mental component of HRQoL is the most involved dimension. Moreover, there are no differences in the HRQoL among ED groups, even if AN patients in some studies have a lower HRQoL scores. Furthermore, BED patients have a poorer HRQoL than obese patients who do not have binge episodes. Finally, all treatments were positively correlated with an improvement on general and specific QoL dimensions. In our sample, ED subgroups differed only for Psychological Health HRQoL scores (F = 4.072, df = 3; p = 0.01). No differences were found between inpatients and outpatients, treatment naïve and previously treated patients and patients with or without psychiatric comorbidity. Moreover, HRQoL scores were not correlated to length of illness within each ED subgroup. Conclusions The
Waaddegaard, Mette; Davidsen, Michael; Kjøller, Mette
Possibilities for early identification of eating disorders among 16-29-year-old women are investigated regarding physical and mental health-related determinants. The study was a representative cross-sectional survey of 16-29-year-old women, and was part of the Danish Health Interview Survey 2005. The response rate was 53.3%. Participants responded to RiBED-8, a screening instrument for identification of risk behaviour for eating disorders. Relative Risk (RR) for the development of risk behaviour was shown for each variable to identify the effect on prevalence of risk behaviour for eating disorders. Analyses showed no effect of non-response on prevalence of risk behaviour for eating disorders. 19% of 16-29-year-old women had risk behaviour for eating disorders. Women had a higher RR for developing risk behaviour if they had had sick leave from work, complained of nervousness, anxiety and depression in the last 2-4 weeks, or had had suicidal thoughts within the last year. Furthermore, overweight and a desire to lose weight and intense physical activity were factors connected with risk behaviour. Young women with risk behaviour for eating disorders may be identified since they often present themselves in general practice with mental problems, overweight and a wish to lose weight.
Sharpe, Emma; Wallis, Deborah J.; Ridout, Nathan
This study aimed to: i) determine if the attention bias towards angry faces reported in eating disorders generalises to a non-clinical sample varying in eating disorder-related symptoms; ii) examine if the bias occurs during initial orientation or later strategic processing; and iii) confirm previous findings of impaired facial emotion recognition in non-clinical disordered eating. Fifty-two females viewed a series of face-pairs (happy or angry paired with neutral) whilst their attentional d...
Srinivasan, T.N.; Suresh, T.R.; Jayaram, Vasantha; Fernandez, M. Peter
Data on the nature and extent of major eating disorders, anorexia nervosa and bulimia is lacking in non-white, native populations of the developing world, leaving a gap in understanding the determinants of these disorders. In a study on 210 medical students examined by a two-stage survey method, 31 subjects were found to have distress relating to their eating habits and body size not amounting to criterion-based diagnosis of eating disorders. The characteristics of this eating distress syndro...
Khalil, Rami Bou; El Hachem, Charline
To elucidate the possible role of adiponectin, an adipokine secreted by white adipose tissue that plays an important role in the neuromodulation of food intake, in the pathogenesis of eating disorders. A comprehensive review of the available literature via MedLine is done using the term "adiponectin" in association with one of the following terms: "anorexia nervosa", "bulimia nervosa", "binge eating disorder" or "eating disorders". The majority of studies evaluating serum adiponectin levels in patients with eating disorders show that serum adiponectin levels are increased in patients with anorexia nervosa. After refeeding, adiponectin levels tend to rejoin the levels of healthy individuals. Data concerning serum adiponectin levels in patients with bulimia nervosa show that these levels can be equal, higher or lower than those found in healthy controls and lower than those found in anorexia nervosa patients. Binge eating disorder is accompanied with lower serum adiponectin levels than normal. Adiponectin receptor type 1 seems to be more related to the central pathological effect of adiponectin on eating behavior. The potential role that plays adiponectin in the pathogenesis of eating disorders needs to be elucidated by further studies.
Full Text Available Abstract Introduction Somnambulism or sleepwalking is a disorder of arousal from non-rapid eye movement sleep. The prevalence of sleep-related eating disorder has been found to be approximately between 1% and 5% among adults. Many cases of medication-related somnambulism and sleep-related eating disorder-like behavior have been reported in the literature. Quetiapine, an atypical antipsychotic medication, has been associated with somnambulism but has not yet been reported to be associated with sleep-related eating disorder. Case presentation Case 1 is a 51-year-old obese African American male veteran with a body mass index of 34.11kg/m2 and severe sleep apnea who has taken 150mg of quetiapine at bedtime for more than one year for depression. He developed sleepwalking three to four nights per week which resolved after stopping quetiapine while being compliant with bi-level positive pressure ventilation therapy. At one year follow-up, his body mass index was 32.57kg/m2. Case 2 is a 50-year-old African American female veteran with a body mass index of 30.5kg/m2 and mild sleep apnea who has taken 200mg of quetiapine daily for more than one year for depression. She was witnessed to sleepwalk three nights per week which resolved after discontinuing quetiapine while being treated with continuous positive airway pressure. At three months follow-up, her body mass index was 29.1kg/m2. Conclusion These cases illustrate that quetiapine may precipitate complex motor behavior including sleep-related eating disorder and somnambulism in susceptible patients. Atypical antipsychotics are commonly used in psychiatric and primary care practice, which means the population at risk of developing parasomnia may often go unrecognized. It is important to recognize this potential adverse effect of quetiapine and, to prevent injury and worsening obesity, discuss this with the patients who are prescribed these medications.
Many adolescents and young adults, especially young females, suffer from eating disorders or problematic nutrition behavior. Children and adolescents with migration background as well as from a lower social class are more likely to have eating disorders 1. Although schools are an important context in these age groups, there is a lack of scientific inquiry concerning the relationship between schooling and eating disorders. The present study investigates the relationship between performance-related stress at school and eating disorders while controlling for personnel and familial resources. Interview data on the 7 th grade high school students from the National Educational Panel Study (NEPS)* starting cohort 3 are used. The dependent variable is based on the SCOFF questionnaire. Logistic regressions are calculated using information from students and parents. Performance-related stress at school is operationalized by the negative deviation of realistic from idealistic educational aspirations (EA) and unfulfilled social expectations (SE), performance-oriented class climate is operationalized by students' perception of the performance-orientation of the teacher (PT) and the expectations of classmates (EC). The results point towards an increased risk of suffering from an eating disorder due to performance-related school stress (EA: AME: 0.18; p<0.001; SE: AME: 0.12; p<0.05) and performance-oriented class climate (PT: AME: 0.05; p<0.1; EC: AME: 0.15, p<0.01). They partly explain the relation between both migration background and educational background and eating disorders. In order to prevent eating disorders in female high school students, attention should be paid to performance-orientation experienced at school and in the social background, and improved individual support for disadvantaged students should be made available. © Georg Thieme Verlag KG Stuttgart · New York.
Vossbeck-Elsebusch, Anna N; Waldorf, Manuel; Legenbauer, Tanja; Bauer, Anika; Cordes, Martin; Vocks, Silja
Body-related avoidance behavior, e.g., not looking in the mirror, is a common feature of eating disorders. It is assumed that it leads to insufficient feedback concerning one's own real body form and might thus contribute to distorted mental representation of one's own body. However, this assumption still lacks empirical foundation. Therefore, the aim of the present study was to examine the relationship between misperception of one's own body and body-related avoidance behavior in N = 78 female patients with Bulimia nervosa and eating disorder not otherwise specified. Body-size misperception was assessed using a digital photo distortion technique based on an individual picture of each participant which was taken in a standardized suit. In a regression analysis with body-related avoidance behavior, body mass index and weight and shape concerns as predictors, only body-related avoidance behavior significantly contributed to the explanation of body-size overestimation. This result supports the theoretical assumption that body-related avoidance behavior makes body-size overestimation more likely.
Full Text Available Eating disorders are considered chronic diseases of civilization. The most studied and well known are anorexia and bulimia nervosa. Anorexia is considered one of the most common psychiatric problems of girls in puberty and adolescence. Due to high mortality and morbidity as well as the increasing expansion of these diseases, it is clear why the amount of research on these diseases is growing worldwide. Eating disorders lead to numerous medical complications, mostly due to late diagnosis. The main characteristic of these diseases is changed behavior in the nutrition, either as an intentional restriction of food, i.e. extreme dieting, or overeating, i.e. binge eating. Extreme dieting, skipping meals, self-induced vomiting, excessive exercise, and misuse of laxatives and diuretics for the purpose of maintaining or reducing body weight are characteristic forms of compensatory behavior of patients with eating disorder. The most appropriate course of treatment is determined by evaluating the patient’s health condition, associated with behavior and eating habits, the experience of one’s own body, character traits of personality, and consequently the development and functioning of the individual. The final treatment plan is individual. Eating disorders are a growing medical problem even in this part of the world. Prevention should be planned in cooperation with different sectors so as to stop the epidemic of these diseases.
Waller, Glenn; Kyriacou Marcoulides, Olivia
This study examined the utility of a transdiagnostic measure of safety behaviours [Brief Safety Behaviours Scale (BSBS)] in eating disorders. Prior to treatment, a group of 102 women with eating disorders completed the BSBS and well-validated measures of eating pathology, anxiety and intolerance of uncertainty. The BSBS had three factors, suggesting that avoidant, checking and social safety behaviours are distinct constructs in the eating disorders. This three-scale scoring system showed greater clinical precision in correlations with eating pathology than the original two-scale version. The pattern of safety behaviours in the eating disorders is more specific than had previously been shown in other clinical samples. While it is important to consider eating-related safety behaviours in the eating disorders (e.g. restriction, body checking), it is also necessary to consider the role of generic safety behaviours when assessing, formulating and treating eating disorders. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.
Jenkins, Paul E; Hoste, Renee Rienecke; Doyle, Angela Celio; Eddy, Kamryn; Crosby, Ross D; Hill, Laura; Powers, Pauline; Mitchell, James E; Le Grange, Daniel
Health-related quality of life (HRQoL) is an emerging area of research in eating disorders (EDs) that has not been examined in adolescents in detail. The aim of the current study is to investigate HRQoL in an adolescent ED sample, examining the impact of ED symptoms on HRQoL. Sixty-seven treatment-seeking adolescents (57 females) with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorder not otherwise specified (EDNOS) completed self-report measures of HRQoL and ED symptoms. Participants reported poorer HRQoL in mental health domains than in physical health domains. Disordered attitudes, binge eating, and compensatory behaviors were associated with poorer mental health HRQoL, and body dissatisfaction was associated with poorer physical health HRQoL. The current study assessed HRQoL among adolescents with EDs, finding several consistencies with the literature on adults with EDs. Future research should compare adolescents and adults with EDs on HRQoL. Copyright © 2013 Elsevier Inc. All rights reserved.
Haycraft, Emma; Blissett, Jackie
This study aimed to examine associations between symptoms of eating disorders and parenting style, in a non-clinical sample. One hundred and five mothers completed self-report measures of eating disorder symptoms and parenting style. Higher levels of eating disorder symptoms were associated with more authoritarian and permissive parenting styles. Authoritative parenting was not significantly related to eating disorder symptoms. The findings demonstrate that eating disorder symptoms in non-clinical individuals are related to less adaptive parenting styles. These findings have potential implications for clinicians working with mothers with eating disorders. 2009 Elsevier Ltd. All rights reserved.
Svaldi, Jennifer; Schmitz, Florian; Trentowska, Monika; Tuschen-Caffier, Brunna; Berking, Matthias; Naumann, Eva
The present study was concerned with cognitive interference and a specific memory bias for eating-related stimuli in binge eating disorder (BED). Further objectives were to find out under which circumstances such effects would occur, and whether they are related with each other and with reported severity of BED symptoms. A group of women diagnosed with BED and a matched sample of overweight controls completed two paradigms, an n-back task with lures and a recent-probes task. The BED group generally experienced more interference in the n-back task. Additionally, they revealed selectively increased interference for food items in the recent-probes task. Findings can be reconciled with the view that control functions are generally impaired in BED, and that there is an additional bias for eating-related stimuli, both of which were related with reported severity of BED symptoms. Copyright © 2013 Elsevier Ltd. All rights reserved.
Schenck, C H; Hurwitz, T D; O'Connor, K A; Mahowald, M W
Sleep-related eating disorders distinct from daytime eating disorders have recently been shown to be associated with sleepwalking (SW), periodic limb movement (PLM) disorder and triazolam abuse in a series of 19 adults. We now report eight other primary or combined etiologies identified by clinical evaluations and polysomnographic monitoring of 19 additional adults (mean age 40 years; 58% female): i) obstructive sleep apnea (OSA), with eating during apnea-induced confusional arousals (n = 3); ii) OSA-PLM disorder (n = 1); iii) familial SW and sleep-related eating (n = 2); iv) SW-PLM disorder (n = 1); v) SW-irregular sleep/wake pattern disorder (n = 1); vi) familial restless legs syndrome and sleep-related eating (n = 2); vii) anorexia nervosa with nocturnal bulimia (n = 2) and viii) amitriptyline treatment of migraines (n = 1). In our cumulative series of 38 patients (excluding six with simple obesity from daytime overeating), 44% were overweight (i.e. > 20% excess weight) from sleep-related eating. Nightly sleep-related binge eating (without hunger or purging) had occurred in 84% of patients. Onset of sleep-related eating was also closely linked with i) acute stress involving reality-based concerns about the safety of family members or about relationship problems (n = 6), ii) abstinence from alcohol and opiate/cocaine abuse (n = 2) and iii) cessation of cigarette smoking (n = 2). Current treatment data indicate a primary role of dopaminergic agents (carbidopa/L-dopa; bromocriptine), often combined with codeine and clonazepam, in controlling most cases involving SW and/or PLM disorder. Fluoxetine was effective in two of three patients. Nasal continuous positive airway pressure therapy controlled sleep-related eating in two OSA patients.
In June 2015, the newspapers in England once again pointed at the media industry as responsible for the spread of eating disorders. This article reviews this argument and previous research on the role of the media industry in the perpetration of images that may foster eating disorders. It has been recently argued, coherently with previous research, that the media may be responsible for the spread of eating disorders. This article reviews this literature, and evaluates what the real role of the media in the spread of eating disorders is. The article argues that considering the portrait of thin models in the media industry as responsible for eating disorders is a misanalysis of the problem and evaluates some of the more profound reasons that may lead to the adoption of the disordered eating symptomatology.
Abraham, Suzanne F; Brown, Tani; Boyd, Catherine; Luscombe, Georgina; Russell, Janice
There is a lack of measurements with predictive validity that are specific for quality of life (QOL) in patients with eating disorders. A total of 306 eating disorder patients treated as inpatients completed the Quality of Life for Eating Disorders (QOL ED): 109 at both admission and discharge from hospital, 65 at both admission and after 12 months. Patients also completed well-validated measures of eating disorders, psychological dysfunction and general physical and mental QOL. QOL ED consists of 20 self-report questions that provide scores for the domains of behaviour, eating disorder feelings, psychological feelings, effects on daily life, effects on acute medical status and body weight, and a global score. QOL ED domain scores correlated appropriately with previously validated well-known measures of eating disorders, psychological dysfunction, general QOL and behaviour and body weight (p eating disorder not specified (EDNOS) and no diagnosis. All no diagnosis (recovered) domain and global scores were significantly different from all diagnoses scores (p eating disorders, including outcome.
Averett, Susan L.; Terrizzi, Sabrina; Wang, Yang
Eating disorders affect 12-25% of college women. Previous research established a positive correlation between sorority membership and eating disorders. We investigate a possible causal link between sororities and weight-related behaviors and eating disorders using data from the American College Health Association. Using Propensity Score Matching and Instrumental Variable methods, we confirm that sororities exert a negative effect on the weight-related behaviors of their members. However, fema...
Mustelin, Linda; Bulik, Cynthia M; Kaprio, Jaakko; Keski-Rahkonen, Anna
Binge eating disorder (BED) is associated with high levels of obesity and psychological suffering, but little is known about 1) the distribution of features of BED in the general population and 2) their consequences for weight development and psychological distress in young adulthood. We investigated the prevalence of features of BED and their association with body mass index (BMI) and psychological distress among men (n = 2423) and women (n = 2825) from the longitudinal community-based FinnTwin16 cohort (born 1975-1979). Seven eating-related cognitions and behaviors similar to the defining features of BED were extracted from the Eating Disorder Inventory-2 and were assessed at a mean age of 24. BMI and psychological distress, measured with the General Health Questionnaire, were assessed at ages 24 and 34. We assessed prevalence of the features and their association with BMI and psychological distress cross-sectionally and prospectively. More than half of our participants reported at least one feature of BED; clustering of several features in one individual was less common, particularly among men. The most frequently reported feature was 'stuffing oneself with food', whereas the least common was 'eating or drinking in secrecy'. All individual features of BED and their clustering particularly were associated with higher BMI and more psychological distress cross-sectionally. Prospectively, the clustering of features of BED predicted increase in psychological distress but not additional weight gain when baseline BMI was accounted for. In summary, although some features of BED were common, the clustering of several features in one individual was not. The features were cumulatively associated with BMI and psychological distress and predicted further increase in psychological distress over ten years of follow-up. Copyright © 2016. Published by Elsevier Ltd.
Full Text Available Yoko Komada,1 Yoshikazu Takaesu,2 Kentaro Matsui,3 Masaki Nakamura,3 Shingo Nishida,3 Meri Kanno,3,† Akira Usui,3 Yuichi Inoue1,3 1Department of Somnology, 2Department of Psychiatry, Tokyo Medical University, 3Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan †Meri Kanno passed away on March 1, 2016 Purpose: The aim of this study was to ascertain the clinical characteristics of drug-induced sleep-related eating disorder (SRED. Patients and methods: We retrospectively reviewed the medical records of 30 patients with primary SRED (without any comorbid sleep disorders and who were not taking any possible causative medications, and ten patients with drug-induced SRED (occurrence of SRED episodes after starting nightly medication of sedative drugs, which completely resolved after dose reduction or discontinuation of the sedatives. Results: All patients with drug-induced SRED took multiple types of sedatives, such as benzodiazepines or benzodiazepine receptor agonists. Clinical features of drug-induced SRED compared with primary SRED were as follows: higher mean age of onset (40 years old in drug-induced SRED vs 26 years old in primary SRED, significantly higher rate of patients who had total amnesia during most of their SRED episodes (75.0% vs 31.8%, significantly lower rate of comorbidity of night eating syndrome (0% vs 63.3%, and significantly lower rate of history of sleepwalking (10.0% vs 46.7%. Increased doses of benzodiazepine receptor agonists may be responsible for drug-induced SRED. Conclusion: The clinical features of drug-induced SRED were different from those of primary SRED, possibly reflecting differences in the underlying mechanisms between these two categories of SREDs. Keywords: nocturnal eating syndrome, night eating, eating disorder, hypnotics, amnesia, sleepwalking, benzodiazepine
Aneta Michalska; Natalia Szejko; Andrzej Jakubczyk; Marcin Wojnar
Aim. The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa). Method. The Medline database was searched for articles on nonspecific eating disorders. The following disorders were described: binge eating disorder (BED), pica, rumination disorder, avoidant/restrictive food intake disorder, night eating syndrome (NES), sleep-related eating disorder (SRED), bigorexia, orthorexia, focusing on diagnosis, symptoms, assessment, comorbid...
SOUTO, Daniella Fagundes; COSTA, Bruno Arlindo de Oliveira; OLIVEIRA, Arlete Maria Gomes; FLÓRIO, Flávia Martão; ZANIN, Luciane
Abstract Introduction The overvaluation of thinness as a standard of beauty has contributed to the development of eating disorders and has mainly affected adolescents and young adults. Objective To evaluate the prevalence of risk behaviors for eating disorders and their association with dental erosion in adolescents. Material and method This is a cross-sectional observational epidemiological study. The sample consisted of 278 adolescents aged 12 to 19 years, enrolled in a State School in C...
Full Text Available Hunger is an awakening related biological impulse. The relationship between hunger and sleep is moderated by the control of homeostatic and circadian rhytms of the body. Abnormal eating behavior during sleep period could result from different causes. Abnormal eating during the main sleep period has been categorized as either night eating syndrome or sleep related eating disorder. Night eating syndrome (NES is an eating disorder characterised by the clinical features of morning anorexia, evening hyperphagia, and insomnia with awakenings followed by nocturnal food ingestion. Recently night eating syndrome, conceptualized as a delayed circadian intake of food. Sleep-related eating disorder, thought to represent a parasomnia and as such included within the revised International Classification of Sleep Disorders (ICSD-2, and characterized by nocturnal partial arousals associated with recurrent episodes of involuntary food consumption and altered levels of consciousness. Whether, however, sleep-related eating disorder and night eating syndrome represent different diseases or are part of a continuum is still debated. This review summarizes their characteristics, treatment outcomes and differences between them.
Gale, Leigh; Channon, Sue; Larner, Mike; James, Darren
Previous research into the impact of pro-eating disorder (pro-ED) websites has predominantly been undertaken using experimental and survey designs. Studies have used both clinical and non-clinical (college student) samples. The present study aimed to explore the underlying functions and processes related to the access and continued use of pro-ED websites within a clinical eating disorder population using a qualitative research design. Participants were recruited through NHS community mental health teams and specialist eating disorder services within South Wales, UK. Face-to-face semi-structured interviews were conducted with seven adult women in treatment for an eating disorder who had disclosed current or historic use of pro-ED websites. Interviewees ranged in age from 20 to 40 years (M = 31.2; SD = 7.8). Constructivist Grounded Theory was used to analyse interview transcripts. Five key themes were identified within the data, namely fear; ambivalence; social comparisons; shame; and pro-ED websites maintaining eating disordered behaviour. The pro-ED websites appeared to offer a sense of support, validation and reassurance to those in the midst of an eating disorder, whilst simultaneously reinforcing and maintaining eating disordered behaviour. Themes are discussed in relation to implications and recommendations for clinical practice. Limitations of the present study and suggestions for future research are also outlined.
Díaz-Marsá, Marina; Carrasco, Jose L; de Anta, Laura; Molina, Rosa; Sáiz, Jerónimo; Cesar, Jesus; López-Ibor, Juan J
Increased and decreased levers of platelet monoamine oxidase (MAO) activity have been reported in patients with eating disorders, indicating abnormalities of the serotonin turnover. However, whether these findings are related to eating disorders or are rather reflecting the pathophysiology of borderline personality traits in these patients is still unknown. Platelet MAO activity and comorbid personality disorders were investigated in 72 patients with different subtypes of eating disorders (ED) and in a group of 28 healthy controls. ED patients comprised the following subtypes: 25 anorexia nervosa (AN) restrictive, 14 AN binge eating-purging (AN b-p), 3 anorexia nervosa not otherwise specified (AN NOS) and 30 bulimia nervosa (BN). Personality disorders and traits were assessed with the Structured Interview for Personality Disorders (SCID-II), the Zanarini Rating Scale for Borderline Personality Disorder, and the Barrat Impulsiveness Scale. Platelet MAO activity was significantly lower in ED patients with comorbid borderline personality disorder (BPD) than in ED without Borderline personality disorder (BDP). Platelet MAO activity was significantly and inversely correlated with the number and severity of BPD clinical features. In the subsample of patients with binge eating-purging symptoms (AN b-p, AN NOS and BN), platelet MAO activity was significantly lower in binge-purge patients with comorbid BPD than in binge-purge patients without BPD. The whole group of eating disorders had a significantly reduced lever of platelet MAO activity compared with the control group. The results suggest that low platelet MAO activity might characterize eating disorders with comorbid borderline personality traits, reflecting greater serotonin dysfunction in these patients. The role of decreased platelet MAO as an endophenotype with specific clinical manifestations should be explored in future studies. Copyright © 2011. Published by Elsevier Ireland Ltd.
Full Text Available Gunn Pettersen,1 Kari-Brith Thune-Larsen,2 Jan H Rosenvinge31Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway; 2Oslo University Hospital, Oslo, Norway; 3Department of Psychology, Faculty of Health Sciences, University of Tromsø, Tromsø, NorwayAbstract: Although there are numerous lists of items covering clinically valid aspects of recovery from eating disorders, these lists are on the nominal level: the potential for multidimensional development has not been explored. Such exploration is the purpose of the present study. The subjects included in the study were 152 female clinicians, 1052 females randomly selected from the general population, and 184 eating-disorder patients. All subjects rated 17 recovery items on a 10-point scale in terms of their relevance and importance. They also completed measures of knowledge about eating disorders and their own eating problems, in addition to providing information about their age and personal acquaintance with eating disorders. Fourteen recovery-item scores were sample unspecific, and hence all samples tended to judge the majority of items in a similar manner. The 17 items successfully formed three separate factors covering specific eating-disorder symptoms, as well as social and psychological issues. The clinician and general population sample analyzed together provided a more condensed scale comprising two factors (specific eating-disorder symptoms and psychosocial factors, with each factor having three items. This factor structure was successfully replicated using the patient-validation sample. The findings indicate an empirical basis for a valid recovery measure that may be suitable in future outcome research.Keywords: eating disorders, recovery, outcome, outcome measures
Santin, Julia; Mery, Victoria; Elso, María José; Retamal, Eva; Torres, Catalina; Ivelic, José; Godoy, Jaime
We aimed to describe a group of adults diagnosed with sleep-related eating disorder (SRED) at the Sleep Medicine Center of the Pontificia Universidad Catolica de Chile. We performed a descriptive study of 34 consecutive patients who met the criteria of the International Classification of Sleep Disorders for SRED evaluated during a 3-year period who did not have an eating disorder according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. All patients had a structured clinical interview performed by a sleep specialist and completed the Beck Depression Inventory (BDI). Polysomnography (PSG) was performed when clinically indicated for ruling out other sleep-related disorders (18 patients; 52.9%). Patients' demographic and clinical data, comorbidities, and treatment response also were analyzed. Most patients were women (n=23; 67.6%). The average age at the time of diagnosis was 39±13.8 (17-67 years) and the latency since symptom onset was 8.3±8.8 years. Most patients had several episodes per night (average, 2.6±1.6; 1-8) and all except one patient had partial or total amnesia of these events (n=33; 97%). Comorbidities were frequent and included insomnia (n=20; 58.8%), restless legs syndrome (RLS) (n=16; 47%), sleep-disordered breathing (SDB) (n=9; 26%), psychiatric disorders (n=13; 38.2%), and overweight or obesity (n=14; 41.1%). Most patients were hypnotic users (n=21; 61.7%) and reported weight-centered anxiety (n=23; 67.6%). Twenty patients (58.8%) were treated with topiramate, 17 of whom had adequate symptomatic responses. Our SRED patients showed female preponderance, amnesia during the episodes, association with other sleep disorders, use of hypnotics, weight-centered anxiety, and positive response to topiramate. The presence of anxiety focused on weight in most patients may be an important element in the emergence of this behavior during sleep. Copyright © 2013 Elsevier B.V. All rights reserved.
Gilboa-Schechtman, Eva; Avnon, Liora; Zubery, Eynat; Jeczmien, Pablo
The literature on eating disorders emphasizes the relationship between alexithymia and anorexia nervosa on the one hand, and between bulimia nervosa and affect dysregulation on the other. In our study, two questions are addressed: (1) Are there different patterns of emotional processing deficiencies in anorexia and bulimia? and (2) Is there a unique contribution of eating disorders to emotional processing deficiencies? Participants were women with anorexia nervosa (ANs, n=20), bulimia nervosa (BNs, n=20), and normal controls (NCs, n=20). Three hypotheses were examined: (1) Women with eating disorders will exhibit lower emotional awareness and more deficient emotional regulation than will NCs (emotional deficiency); (2) ANs will be less emotionally aware than BNs, whereas BNs will be less capable of effective emotional regulation than ANs (disorder specificity); and (3) emotional distress will mediate the relationships between emotional processing and eating disorders (emotional distress mediation). Results supported the emotional deficiency and distress mediation hypotheses, and partially supported the disorder specificity hypothesis. The need to move beyond alexithymia in understanding the pattern of emotional processing deficiencies in eating disorders is discussed.
Schag, K; Schönleber, J; Teufel, M; Zipfel, S; Giel, K E
Impulsivity towards food has been recognized as a potential factor leading to increased food intake in obesity. Patients suffering from binge eating disorder (BED) form a specific subgroup of obese people that might be characterized by increased impulsivity. These assumptions, although, have yet to be verified. Therefore, this review evaluates evidence for food-related impulsivity in obese people with and without BED and examines possible differences between both populations. More precisely, evidence for the two components of impulsivity is analyzed separately: evidence for reward sensitivity, specifically, the urge for appetitive stimuli and evidence for rash-spontaneous behaviour such as acting disinhibited with no regard for the consequences. Our search resulted in 51 articles demonstrating generally increased food-related impulsivity. We found particular emphasis on increased reward sensitivity in obese people, which appeared to be more pronounced in people with BED. There was little and conflicting evidence, however, concerning increased rash-spontaneous behaviour in obese people without BED, but consistent evidence of an increase in obese people with BED. All in all, the evidence supports the view that BED represents a specific phenotype of obesity with increased food-related impulsivity. Taking these specific deficits into account can enhance the effectiveness of weight reduction programmes and psychotherapy. © 2013 The Authors. obesity reviews © 2013 International Association for the Study of Obesity.
Eating disorders (EDs), including anorexia nervosa, bulimia nervosa, and binge-eating disorder, constitute a class of common and deadly psychiatric disorders. While numerous studies in humans highlight the important role of neurobiological alterations in the development of ED-related behaviors, the precise neural substrate that mediates this risk is unknown. Historically, pharmacological interventions have played a limited role in the treatment of eating disorders, typically providing symptomatic relief of comorbid psychiatric issues, like depression and anxiety, in support of the standard nutritional and psychological treatments. To date there are no Food and Drug Administration-approved medications or procedures for anorexia nervosa, and only one Food and Drug Administration-approved medication each for bulimia nervosa (fluoxetine) and binge-eating disorder (lisdexamfetamine). While there is little primary interest in drug development for eating disorders, postmarket monitoring of medications and procedures approved for other indications has identified several novel treatment options for patients with eating disorders. In this review, I utilize searches of the PubMed and ClinicalTrials.gov databases to highlight emerging treatments in eating disorders.
Jáuregui-Garrido, Beatriz; Jáuregui-Lobera, Ignacio
Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. "Sudden death" has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds) must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.
Palmisano, Giovanni Luca; Innamorati, Marco; Vanderlinden, Johan
Background and aims Several studies report a positive association between adverse life experiences and adult obesity. Despite the high comorbidity between binge eating disorder (BED) and obesity, few authors have studied the link between trauma and BED. In this review the association between exposure to adverse life experiences and a risk for the development of obesity and BED in adulthood is explored. Methods Based on a scientific literature review in Medline, PubMed and PsycInfo databases, the results of 70 studies (N = 306,583 participants) were evaluated including 53 studies on relationship between adverse life experiences and obesity, 7 studies on post-traumatic stress disorder (PTSD) symptoms in relation to obesity, and 10 studies on the association between adverse life experiences and BED. In addition, mediating factors between the association of adverse life experiences, obesity and BED were examined. Results The majority of studies (87%) report that adverse life experiences are a risk factor for developing obesity and BED. More precisely a positive association between traumatic experiences and obesity and PTSD and obesity were found, respectively, in 85% and 86% of studies. Finally, the great majority of studies (90%) between trauma and the development of BED in adulthood strongly support this association. Meanwhile, different factors mediating between the trauma and obesity link were identified. Discussion and conclusions Although research data show a strong association between life adverse experiences and the development of obesity and BED, more research is needed to explain this association. PMID:28092189
Palmisano, Giovanni Luca; Innamorati, Marco; Vanderlinden, Johan
Background and aims Several studies report a positive association between adverse life experiences and adult obesity. Despite the high comorbidity between binge eating disorder (BED) and obesity, few authors have studied the link between trauma and BED. In this review the association between exposure to adverse life experiences and a risk for the development of obesity and BED in adulthood is explored. Methods Based on a scientific literature review in Medline, PubMed and PsycInfo databases, the results of 70 studies (N = 306,583 participants) were evaluated including 53 studies on relationship between adverse life experiences and obesity, 7 studies on post-traumatic stress disorder (PTSD) symptoms in relation to obesity, and 10 studies on the association between adverse life experiences and BED. In addition, mediating factors between the association of adverse life experiences, obesity and BED were examined. Results The majority of studies (87%) report that adverse life experiences are a risk factor for developing obesity and BED. More precisely a positive association between traumatic experiences and obesity and PTSD and obesity were found, respectively, in 85% and 86% of studies. Finally, the great majority of studies (90%) between trauma and the development of BED in adulthood strongly support this association. Meanwhile, different factors mediating between the trauma and obesity link were identified. Discussion and conclusions Although research data show a strong association between life adverse experiences and the development of obesity and BED, more research is needed to explain this association.
Koushiou, Maria; Nicolaou, Kalia; Karekla, Maria
The aim of the present study was to select appropriate film clips with a general vs. eating disorder (ED)-related content to induce negative affect. More specifically, the study examined the subjective emotional experience (valence, arousal, anxiety, induction of somatic symptoms, and ability to control reactions during film clips) of Greek-Cypriot university students (N = 79) in response to three types of film clips: general unpleasant, ED-specific unpleasant, and emotionally neutral. In addition, the study aimed to compare the emotional reactions to the aforementioned clips between two groups of participants differing on their risk for ED (high vs. low). Preliminary results indicate the clips with general content ("The Champ") and with ED-specific content ("Binge eating") that are most effective in inducing negative affect and differentiating between risk groups. These clips provide an effective method for emotion induction that can be used for assessing the emotional experience of individuals with ED symptoms, since their emotional experience is significantly implicated in the development and maintenance of their symptoms (Merwin, Clin Psychol Sci Pract 18(3):208-214, 2011).Level of evidence No level of evidence, Experimental Study.
Rikani, Azadeh A; Choudhry, Zia; Choudhry, Adnan M; Ikram, Huma; Asghar, Muhammad W; Kajal, Dilkash; Waheed, Abdul; Mobassarah, Nusrat J
The development of eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, and atypical eating disorders that affect many young women and even men in the productive period of their lives is complex and varied. While numbers of presumed risk factors contributing to the development of eating disorders are increasing, previous evidence for biological, psychological, developmental, and sociocultural effects on the development of eating disorders have not been conclusi...
Grunwald, Martin; Wesemann, Dorette
In the treatment of chronic diseases, programs that use the internet as a medium are becoming more and more important as a complement to classical intervention techniques. Since 1998, a non-profit information and online consulting service for patients with eating disorders and their friends and relatives (www.ab-server.de) has existed. This was established by members of the Deutsche Forschungsinitiative Essstörungen e.V. (DFE) [German Research Initiative for Eating Disorders] and members of the Clinic of Psychiatry, University of Leipzig, Germany. For the present study, 2,176 e-mail requests from users of the online consultation service were analyzed qualitatively and quantitatively in order to better understand the differences between different types and groups of users. The analysis was related to the social field of the person requesting the consultation, the type of disorder reported, and the content of the e-mail request. Three main user groups could be identified: people who described themselves as having an eating disorder (57.2%), people who were related socially to the affected person (32.4%), and interested persons (9.8%). The consulting service was predominantly used by persons suffering from bulimia nervosa or their families and friends (63.1%). One third (33.3%) of the posted e-mails were related to behavioral patterns in dealing with the illness and the affected person. They were followed by inquiries for information about the disease (18.7%) and by those seeking help in finding specialized clinics/therapists and places in therapies. The increasing use of the online consulting service indicates that there is a substantial need for information and help in persons with eating disorders and in their relatives, who are able to easily contact professionals using this online service. Online consulting has a high potential for complementary care of affected people.
Racine, Sarah E; Hebert, Karen R; Benning, Stephen D
Eating disorders are associated with both negative and positive emotional reactions towards food. Individual eating disorder symptoms may relate to distinct emotional responses to food, which could necessitate tailored treatments based on symptom presentation. We examined associations between eating disorder symptoms and psychophysiological responses to food versus neutral images in 87 college students [mean (SD) age = 19.70 (2.09); mean (SD) body mass index = 23.25(2.77)]. Reflexive and facial electromyography measures tapping negative emotional reactivity (startle blink reflex) and appraisal (corrugator muscle response) as well as positive emotional reactivity (postauricular reflex) and appraisal (zygomaticus muscle response) were collected. Eating disorder cognitions correlated with more corrugator activity to food versus neutral images, indicating negative appraisals of food. Binge eating was associated with increased postauricular reflex reactivity to food versus neutral images, suggesting enhanced appetitive motivation to food. The combination of cognitive eating disorder symptoms and binge eating may result in motivational conflict towards food. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
Blomquist, Kerstin K.; Milsom, Vanessa A.; Barnes, Rachel D.; Boeka, Abbe G.; White, Marney A.; Masheb, Robin M.; Grilo, Carlos M.
The metabolic syndrome (MetSyn), characterized by vascular symptoms, is strongly correlated with obesity, weight-related medical diseases and mortality, and has increased commensurately with secular increases in obesity in the U.S. Little is known about the distribution of MetSynin obese patients with binge eating disorder (BED) or its associations with different developmental trajectories of dieting, binge eating, and obesity problems. Further, inconsistencies in the limited data necessitate...
Araujo, Daniele Marano Rocha; Santos, Giovana Fonseca da Silva; Nardi, Antonio Egídio
The purpose of this systematic literature review is to examine previous studies that investigated the relation between depression and binge eating disorder (BED). Medline/PubMed published data from 1980 through 2006 was tracked using the following keywords: "binge eating disorder and depression", "periodic binge eating and depression", "binge eating disorder" and "periodic binge eating". The findings of 14 studies were successfully highlighted: one cohort, four cross-sectional and nine case-control studies. Most studies (7/14) were conducted in the United States, with missing data varying between 2.3 and 44.32%, and seven studies emphasizing the most important variables. The majority of the studies (10/14) showed an association between depression and binge eating disorder, but carefully designed studies are required to minimize the limitations found in these studies.
Daniella Fagundes SOUTO
Full Text Available Abstract Introduction The overvaluation of thinness as a standard of beauty has contributed to the development of eating disorders and has mainly affected adolescents and young adults. Objective To evaluate the prevalence of risk behaviors for eating disorders and their association with dental erosion in adolescents. Material and method This is a cross-sectional observational epidemiological study. The sample consisted of 278 adolescents aged 12 to 19 years, enrolled in a State School in Campinas - SP. Two questionnaires were used for the data collection on eating disorders: Bulimic Investigatory Test of Edinburgh and Eating Attitudes Test -26. The presence of erosion was evaluated by calibrated examiners. Result The mean age of the sample was 14.8 years. The prevalence of mean risk for bulimia in the sample was 43.2% (95% CI: 37.3%-49.0% and the prevalence of adolescents with a probability of developing bulimia was 53.2% (95% CI: 47.4%-59.1%. Of the total, 11.9% (95% CI: 8.1%-15.7% showed results suggestive of anorexia. Among women, 66.9% were classified as probability developing bulimia, whereas in men the prevalence was 39.0%. As for dental erosion, only 1.1% of the sample presented erosion. Conclusion The study pointed to large number of adolescents with risk behaviors for eating disorders but no association was found with dental erosion due to low prevalence.
Murakami, Jessica M; Essayli, Jamal H; Latner, Janet D
Anorexia nervosa (AN), bulimia nervosa (BN), binge-eating disorder (BED), and obesity are stigmatized conditions known to affect both men and women. However, little research has examined differences in stigmatization of individuals with these diagnoses or the impact of gender on stigmatization. Such perceptions may play an important role in understanding and reducing the stigma associated with weight and dysfunctional eating behaviors. This study investigated stigmatizing attitudes toward eating disorders and obesity in men and women. Participants were university undergraduates (N = 318; 73.6% female; mean age = 21.58 years, SD=3.97) who were randomly assigned to read one vignette describing a male or female target diagnosed with AN, BN, BED, or obesity. Participants then completed measures of stigma and perceived psychopathology. Measures were analyzed using a 4 (target diagnosis) x 2 (target gender) MANOVA and subsequent ANOVAs. Measures of stigma and perceived psychopathology revealed significant main effects for diagnosis (p obesity. Additionally, individuals with AN, BN, and BED were perceived as having significantly more psychological problems and impairment than individuals with obesity. Although individuals with eating disorders and obesity both face stigmatizing attitudes, bias against individuals with AN, BN, and BED may exceed stigma toward obesity in the absence of binge eating. Future research is necessary to address stigmatizing beliefs to reduce and prevent discrimination against both men and women with eating disorders and obesity. Copyright © 2016 Elsevier Ltd. All rights reserved.
Sanchez-Ruiz, Maria Jose; El-Jor, Claire; Abi Kharma, Joelle; Bassil, Maya; Zeeni, Nadine
Disordered eating behaviors are on the rise among youth. The present study investigates psychosocial and weight-related variables as predictors of eating disorders (ED) through disordered eating (DE) dimensions (namely restrained, external, and emotional eating) in Lebanese university students. The sample consisted of 244 undergraduates (143 female) aged from 18 to 31 years (M = 20.06; SD = 1.67). Using path analysis, two statistical models were built separately with restrained and emotional eating as dependent variables, and all possible direct and indirect pathways were tested for mediating effects. The variables tested for were media influence, perfectionism, trait emotional intelligence, and the Big Five dimensions. In the first model, media pressure, self-control, and extraversion predicted eating disorders via emotional eating. In the second model, media pressure and perfectionism predicted eating disorders via restrained eating. Findings from this study provide an understanding of the dynamics between DE, ED, and key personality, emotion-related, and social factors in youth. Lastly, implications and recommendations for future studies are advanced.
Tennoune, Naouel; Legrand, Romain; Ouelaa, Wassila; Breton, Jonathan; Lucas, Nicolas; Bole-Feysot, Christine; do Rego, Jean-Claude; Déchelotte, Pierre; Fetissov, Sergueï O
The biological background of sex-related differences in the development of eating disorders (EDs) is unknown. Recent data showed that gut bacteria Escherichia coli induce autoantibodies against anorexigenic α-melanocyte-stimulating hormone (α-MSH) associated with psychopathology in ED. The aim of this study was to compare the effects of E. coli on feeding and autoantibodies against α-MSH and adrenocorticotropic hormone (ACTH), between female and male rats. Commensal E. coli K12 were given in a culture medium daily to adult Wistar rats by intragastric gavage over a 3-wk period; control rats received culture medium only. Before gavage, E. coli K12 DNA was detected in feces of female but not male rats. E. coli provision was accompanied by an increase in body weight gain in females, but a decrease in body weight gain and food intake in males. Independent of E. coli treatment, plasma levels of anti-α-MSH and ACTH immunoglobulin (Ig)G were higher in female than male rats. Females responded to E. coli by increasing α-MSH IgG levels and affinity, but males by increasing α-MSH IgM levels. Affinity of IgG for ACTH was increased in both E. coli-treated females and males, although with different kinetics. IgG from females stimulated more efficiently α-MSH-induced cyclic adenosine monophosphate production by melanocortin 4 receptor-expressing cells compared with IgG from males. Sex-related response to how E. coli affects feeding and anti-melanocortin hormone antibody production may depend on the presence of these bacteria in the gut before E. coli supplementation. These data suggest that sex-related presence of certain gut bacteria may represent a risk factor for ED development. Copyright © 2015 Elsevier Inc. All rights reserved.
Christina E Wierenga
Full Text Available The primary defining characteristic of a diagnosis of an eating disorder (ED is the disturbance of eating or eating-related behavior that results in the altered consumption or absorption of food (DSM V; American Psychiatric Association, 2013. There is a spectrum, ranging from those who severely restrict eating and become emaciated on one end to those who binge and overconsume, usually accompanied by some form of compensatory behaviors, on the other. How can we understand reasons for such extremes of food consummatory behaviors? Recent work on obesity and substance use disorders has identified behaviors and neural pathways that play a powerful role in human consummatory behaviors. That is, corticostriatal limbic and dorsal cognitive neural circuitry can make drugs and food rewarding, but also engage self-control mechanisms that may inhibit their use. Importantly, there is considerable evidence that alterations of these systems also occur in ED. This paper explores the hypothesis that an altered balance of reward and inhibition contributes to altered extremes of response to salient stimuli, such as food. We will review recent studies that show altered sensitivity to reward and punishment in ED, with evidence of altered activity in corticostriatal and insula processes with respect to monetary gains or losses, and tastes of palatable foods. We will also discuss evidence for a spectrum of extremes of inhibition and dysregulation behaviors in ED supported by studies suggesting that this is related to top-down self-control mechanisms. The lack of a mechanistic understanding of ED has thwarted efforts for evidence-based approaches to develop interventions. Understanding how ED behavior is encoded in neural circuits would provide a foundation for developing more specific and effective treatment approaches.
García-Alandete, Joaquín; Ros, Montserrat Cañabate; Salvador, José Heliodoro Marco; Rodríguez, Sandra Pérez
The aim of this study was to analyze the psychometric properties of the Purpose-In-Life Test (PIL), as well as the age-related differences in meaning in life in women diagnosed with eating disorders. Participants were 250 Spanish women diagnosed with eating disorders who ranged from 12 to 60 years old. Confirmatory Factor Analysis, descriptive analyses, estimation of the internal consistency of the PIL, correlations between the PIL and the Beck Hopelessness Scale (BHS), Overweight Preoccupation Scale (OPS), and Body Investment Scale (BIS), and age differences were calculated. A 19-item model that showed a good fit and internal consistency, a negative correlation between the PIL and both the BHS and OPS, and a positive correlation with the BIS, as well as significant differences between the adolescents and the mature adults, were found. It would be advisable to increase the inclusion of meaning in life in psychotherapeutic interventions with women diagnosed with eating disorders. Copyright © 2017 Elsevier B.V. All rights reserved.
The thesis focuses on knowledge of eating disorders by students of University of South Bohemia. The theoretical part defines particular types of eating disorders and the causes related with this problems. There are possible treatment methods for eating disorders mentioned at the end of this part. The practical part deals with students? awareness of eating disorders. It focuses on students? knowledge of eating disorders and orthorexia nerovosa. The research is based on questionnaire constructi...
Dennard, E Eliot; Richards, C Steven
The eating disorder literature has sought to understand the role of comorbid psychiatric diagnoses and coping in relation to eating disorders. The present research extends these findings by studying the relationships among depression, coping, and the entire continuum of disordered eating behaviors, with an emphasis on subthreshold eating disorders. 109 undergraduate females completed questionnaires to assess disordered eating symptoms, depressive symptoms, and the use of active and avoidant coping mechanisms. Hypotheses were tested using bivariate linear regression and multivariate linear regression. Results indicated that depression was a significant predictor of disordered eating symptoms after controlling for relationships between depression and coping. Although avoidant coping was positively associated with disordered eating, it was not a significant predictor after controlling for depression and coping. Previous research has found associations between depression and diagnosable eating disorders, and this research extends those findings to the entire continuum of disordered eating. Future research should continue to investigate the predictors and correlates of the disordered eating continuum using more diverse samples. Testing for mediation and moderation among these variables may also be a fruitful area of investigation. Published by Elsevier Ltd.
Saekow, Jenine; Jones, Megan; Gibbs, Elise; Jacobi, Corinna; Fitzsimmons-Craft, Ellen E.; Wilfley, Denise; Barr Taylor, C.
Objective: Eating disorders and subclinical eating disorders are serious and disabling diseases with high prevalence rates on college campuses. Many symptomatic students are never screened nor formally diagnosed with an eating disorder and do not receive mental health treatment. Method: This pilot study examines the feasibility, acceptability, and short-term efficacy of a 10-week online intervention, StudentBodies-Eating Disorders, designed to reduce eating disorder symptoms, related psych...
Atiye, Minna; Miettunen, Jouko; Raevuori-Helkamaa, Anu
Although suggested as an important contributor to the development and maintenance of eating disorders, temperament has not previously been studied adopting a meta-analytical approach. We therefore pooled data (N = 14 studies; N = 3315 cases, N = 3395 controls) on Cloninger's temperament traits (novelty seeking, harm avoidance, reward dependence and persistence) in anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and eating disorders not otherwise specified. Persistence was significantly higher than in the controls in all eating disorders except for BED the highest levels being observed in AN. Correspondingly, the highest effect sizes for harm avoidance were seen in AN. Novelty seeking was significantly elevated relative to the controls only in BN. Harm avoidance was significantly lower, and reward dependence was significantly higher in individuals who had recovered from AN than in those who remained ill. Future studies with a longitudinal design are needed to explore the temporal relationships between eating disorders and temperament traits. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
Neeta Misra; Anshul Mehra; Pradyuman Misra; Jaya Mehra
Eating disorders are potentially life-threatening disorders. In this article, we discuss the oral manifestations of eating disorders so as to enable dental practitioners to recognize the effects of eating disorders and to manage the patients with eating disorders.
Thomas, Jennifer J; Eddy, Kamryn T; Murray, Helen B; Tromp, Marilou D P; Hartmann, Andrea S; Stone, Melissa T; Levendusky, Philip G; Becker, Anne E
This study evaluated the relative distribution and inter-rater reliability of revised DSM-5 criteria for eating disorders in a residential treatment program. Consecutive adolescent and young adult females (N=150) admitted to a residential eating disorder treatment facility were assigned both DSM-IV and DSM-5 diagnoses by a clinician (n=14) via routine clinical interview and a research assessor (n=4) via structured interview. We compared the frequency of diagnostic assignments under each taxonomy and by type of assessor. We evaluated concordance between clinician and researcher assignment through inter-rater reliability kappa and percent agreement. Significantly fewer patients received either clinician or researcher diagnoses of a residual eating disorder under DSM-5 (clinician-12.0%; researcher-31.3%) versus DSM-IV (clinician-28.7%; researcher-59.3%), with the majority of reassigned DSM-IV residual cases reclassified as DSM-5 anorexia nervosa. Researcher and clinician diagnoses showed moderate inter-rater reliability under DSM-IV (κ=.48) and DSM-5 (κ=.57), though agreement for specific DSM-5 other specified feeding or eating disorder (OSFED) presentations was poor (κ=.05). DSM-5 revisions were associated with significantly less frequent residual eating disorder diagnoses, but not with reduced inter-rater reliability. Findings support specific dimensions of clinical utility for revised DSM-5 criteria for eating disorders. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
... Videos for Educators Search English Español Kids and Eating Disorders KidsHealth / For Kids / Kids and Eating Disorders What's ... and pee) withdrawing from social activities What Causes Eating Disorders? There really is no single cause for an ...
Poruchy příjmu potravy ve spojitosti s jinými diagnózami. Eating Disorders in Connection with other Diagnoses Bc. Marie Vavrušková The aim of this thesis, which focuses on the topic "Eating Disorders in Connection with Other Diagnoses," is to introduce the different types of eating disorders that have been previously diagnosed (anorexia nervosa, bulimia nervosa, psychogenic overeating and new forms of eating disorders), to specify the medical treatment offered to patients in the Czech Republi...
Rikani, Azadeh A; Choudhry, Zia; Choudhry, Adnan M; Ikram, Huma; Asghar, Muhammad W; Kajal, Dilkash; Waheed, Abdul; Mobassarah, Nusrat J
The development of eating disorders including anorexia nervosa, bulimia nervosa, binge eating disorder, and atypical eating disorders that affect many young women and even men in the productive period of their lives is complex and varied. While numbers of presumed risk factors contributing to the development of eating disorders are increasing, previous evidence for biological, psychological, developmental, and sociocultural effects on the development of eating disorders have not been conclusive. Despite the fact that a huge body of research has carefully examined the possible risk factors associated with the eating disorders, they have failed not only to uncover the exact etiology of eating disorders, but also to understand the interaction between different causes of eating disorders. This failure may be due complexities of eating disorders, limitations of the studies or combination of two factors. In this review, some risk factors including biological, psychological, developmental, and sociocultural are discussed.
Mason, Tyler B; Crosby, Ross D; Kolotkin, Ronette L; Grilo, Carlos M; Mitchell, James E; Wonderlich, Stephen A; Crow, Scott J; Peterson, Carol B
Individuals with obesity and binge eating disorder (BED) report poorer weight-related quality of life (WRQOL) compared to individuals with obesity alone. Cognitive behavioral therapy (CBT), the best available treatment for BED, does not consistently produce weight loss or improvements in weight QOL. The purpose of the current study was to examine baseline and longitudinal associations between eating-related and psychosocial variables and dimensions of weight QOL. We examined associations between predictor variables, including body mass index (BMI), eating disorder (ED) psychopathology, and psychosocial factors, in relation to three dimensions of WRQOL among 171 patients whom received CBT for BED. Participants completed interviews and self-report measures at baseline prior to CBT and at end of treatment. At baseline the following associations were significant: BMI, ED psychopathology, and self-esteem were associated with weight-related self-esteem; gender, BMI, and self-esteem were associated with weight-related public distress (i.e., stigma and worry in public because of one's weight); and age, BMI, and ED psychopathology were associated with weight-related physical function. At end of treatment, the following associations were significant: changes in ED psychopathology and coping predicted weight-related self-esteem; changes in coping and self-esteem predicted weight-related public distress; and changes in BMI and subjective binge eating predicted weight-related physical function. Overall, changes in a number of ED and associated symptoms were associated with improvements in WRQOL. Copyright © 2017 Elsevier Ltd. All rights reserved.
Rodgers, Rachel F; Lowy, Alice S; Halperin, Daniella M; Franko, Debra L
Previous research has indicated that exposure to pro-eating disorder websites might increase eating pathology; however, the magnitude of this effect is unknown. This study aimed to conduct a systematic review and meta-analysis to examine the effect of exposure to pro-eating disorder websites on body image and eating pathology. Studies examining the relationship between exposure to pro-eating disorder websites and eating pathology-related outcomes were included. The systematic review identified nine studies. Findings revealed significant effect sizes of exposure to pro-eating disorder websites on body image dissatisfaction (five studies), d = .41, p = .003; dieting (six studies), d = .68, p eating disorder websites on body image and eating pathology, highlighting the need for enforceable regulation of these websites. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.
Full Text Available Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfactory explanation of the cause can be ascertained. In many cases of sudden death, autopsies do not clarify the main cause. Cardiovascular complications are usually involved in these deaths. The purpose of this review was to report an update of the existing literature data on the main findings with respect to sudden death in eating disorders by means of a search conducted in PubMed. The most relevant conclusion of this review seems to be that the main causes of sudden death in eating disorders are those related to cardiovascular complications. The predictive value of the increased QT interval dispersion as a marker of sudden acute ventricular arrhythmia and death has been demonstrated. Eating disorder patients with severe cardiovascular symptoms should be hospitalized. In general, with respect to sudden death in eating disorders, some findings (eg, long-term eating disorders, chronic hypokalemia, chronically low plasma albumin, and QT intervals >600 milliseconds must be taken into account, and it must be highlighted that during refeeding, the adverse effects of hypophosphatemia include cardiac failure. Monitoring vital signs and performing electrocardiograms and serial measurements of plasma potassium are relevant during the treatment of eating disorder patients.Keywords: sudden death, cardiovascular complications, refeeding syndrome, QT interval, hypokalemia
Juli, Maria Rosaria
The origin and course of eating disorders and nutrition have a multifactorial etiology and should therefore take into consideration: psychological factors, evolutionary, biological and socio-cultural (Juli 2012). Among the psychological factors we will focus on violence (in any form) and in particular on the consequences that they have on women, which vary in severity. Recent studies show that women get sick more than men, both from depression and eating disorders, with a ratio of 2:1; this difference begins in adolescence and continues throughout the course of life (Niolu 2010). The cause of this difference remains unclear. Many studies agree that during adolescence girls have negative feelings more frequently and for a longer duration caused by stressful life events and difficult circumstances, such as abuse or violence. This results in an increased likelihood of developing a symptom that will be connected to eating disorders and/or depression. As far as the role of food is concerned in eating disorders, it has a symbolic significance and offers emotional comfort. Eating means to incorporate and assimilate, and even in an ideal sense, the characteristics of the foods become part of the individual. Feelings that lead to binges with food are normally a result of feelings related to abuse or violence and lead to abnormal behavior which leads to binging and the final result being that the person is left feeling guilty and ashamed. Research confirms that 30% of patients who have been diagnosed with eating disorders, especially bulimia, have a history of sexual abuse during childhood. Ignoring the significance of this factor can result in the unleashing of this disease as the patient uses the disorder as his expressive theater (Mencarelli 2008). Factors that contribute to the possibility of developing an eating disorder are both the age of the patient at the time of the abuse and the duration of the abuse. The psychological effects that follow may include dissociative
Samnaliev, Mihail; Noh, H LeAnn; Sonneville, Kendrin R; Austin, S Bryn
Very little is known about the economic burden of eating disorders (ED) and related mental health comorbidities. Using 5 years of data from the U.S. Medical Expenditures Panel Survey, we estimated the difference in annual health care costs, employment status, and earned income (2011 US$) between individuals with current ED compared to those without ED. We further estimated the contribution of mental health comorbidities to these disparities in health care costs, employment and earnings. Individuals with ED had greater annual health care costs ($1869, p = 0.012), lower but borderline significant employment rates (OR = 0.67, 95% CIs [0.41, 1.09]), and lower but not statistically significant earnings among those who were employed ($2093, p = 0.48), compared to individuals without ED. Among individuals with ED, the presence of mental health comorbidities was associated with higher but not statistically significant health care costs ($1993, p = 0.17), lower borderline significant odds of employment (OR = 0.41, 95% CIs [0.14, 1.20]), and significantly lower earnings ($19,374, p economic benefits in terms of heath care savings and gains in work productivity than previously recognized. This exploratory study justifies large scale evaluations of the societal economic impact of eating disorders and comorbidities.
Manaf, Nurajirahbt Abdul; Saravanan, Coumaravelou; Zuhrah, Beevi
Female students are thought to be more negatively impacted by body image ideals and often more susceptible to various eating related disorders compared to men. A previous study using a sample of female students in Malaysia did not identify whether the increase in susceptibility to eating disorders can be explained by the level of body image acceptance. To identify the prevalence of depression and susceptibility to eating disorders among a sample of 206 female students in one of the private universities in Malaysia and explore the relationship between depression, body image and susceptibility to eating disorders. In addition, this study aimed to determine whether depression is a mediator between body image and susceptibility to eating disorders among female college students. The Body Image Acceptance and Action Questionnaire were used to assess body image acceptance, the Patient Health Questionnaire to measure depression and the Eating Attitude Test- 26 was used to assess susceptibility to eating disorders. The results showed that 65.5% (n=135) of the students were depressed and 6.3% (n=13) were susceptible to eating disorders. There was a significant positive relationship between depression and eating disorders and a negative relationship between body image and depression as well as between body image and eating disorder. Further, the regression model showed that depression was partially mediating the effect of body image on eating disorders. Body image and depression contribute to eating disorders and treating depression could reduce susceptibility to eating disorders.
Chisuwa, Naomi; O'Dea, Jennifer A
This review describes the prevalence of eating disorders and disordered eating behaviors as well as factors influencing body image disturbance amongst Japanese adolescents and compares the prevalence and trends with those of Westernized countries. Although eating disorders have been previously regarded as peculiar to Western society, they are now a more global issue with reports of non-Western countries including Japan having increasing rates of eating disorders. As the aetiology of eating disorders is related to societal norms, culture and ethnicity, their study requires an understanding of body image disturbance within different cultural contexts. Although considered less prevalent than in the West, Japan has an early history of eating disorder research and trends outlined in this review suggest that, as in Western countries the interest in, and study of eating disorders in Japan has increased during the 1980s. The prevalence of eating disorders in Japan based on available reviews, epidemiological studies and clinical reports ranges from 0.025% to 0.2% for AN and from 1.9% to 2.9% for BN. Studies suggest that the prevalence of eating disorders has increased significantly during the past two decades but the prevalence is still quite low compared to those in Western countries. Strategies for culturally appropriate prevention are discussed. 2009 Elsevier Ltd. All rights reserved.
Conason, Alexis H; Sher, Leo
Eating disorders, in particular bulimia nervosa and binge eating disorder are associated with co-morbid alcohol and drug abuse. School-based studies have shown significant associations between bulimic behaviors and various measures of alcohol, cigarette and other drug use and abuse. Amongst bulimic adolescents, substance use is related to an increased likeliness of high risk behaviors such as attempted suicide, stealing and sexual intercourse. In contrast with bulimics and binge eaters, restricting anorexics have low rates of co-morbid substance abuse. It appears that restricting anorexics, binge eaters and bulimics represent distinct subgroups within the eating disordered population and binge eaters and bulimics are more prone to alcohol use. It is possible that individuals with eating disorders turn to alcohol use/abuse as a way of coping with the problems caused by their eating disorder. Researchers have proposed that an addictive personality is an underlying trait, which predisposes individuals to both eating disorders and alcohol abuse. Eating disorders are often conceptualized as an addictive disorder. Opioid antagonists, such as naltrexone, may be useful in treating both eating and alcohol use disorders. There is also evidence that serotonin reuptake inhibitors, which are traditionally used to treat major depression, may be an effective treatment. Cognitive-behavioral therapy has been effective in treating alcohol use and eating disorders individually and may be an effective combined treatment for co-morbid eating disorders and alcohol use. Teaching healthy ways to cope with the stressful situations may also help decrease alcohol use and disordered eating behaviors.
Mayer, Birgit; Muris, Peter; Kramer Freher, Nancy; Stout, Janne; Polak, Marike
Covariation bias refers to the phenomenon of overestimating the contingency between certain stimuli and negative outcomes, which is considered as a heuristic playing a role in the maintenance of certain types of psychopathology. In the present study, covariation bias was investigated within the context of eating pathology. In a sample of 148 adolescents (101 girls, 47 boys; mean age 15.3 years), a priori and a posteriori contingencies were measured between words referring to control and loss of control over eating behavior, on the one hand, and fear, disgust, positive and neutral outcomes, on the other hand. Results indicated that all adolescents displayed an a priori covariation bias reflecting an overestimation of the contingency of words referring to loss of control over eating behavior and fear- and disgust-relevant outcomes, while words referring to control over eating behavior were more often associated with positive and neutral outcomes. This bias was unrelated to level of eating disorder symptoms. In the case of a posteriori contingency estimates no overall bias could be observed, but some evidence was found indicating that girls with higher levels of eating disorder symptoms displayed a stronger covariation bias. These findings provide further support for the notion that covariation bias is involved in eating pathology, and also demonstrate that this type of cognitive distortion is already present in adolescents. Copyright © 2012 Elsevier Ltd. All rights reserved.
Daniel Le Grange
Full Text Available The purpose of this study was to investigate the association between body-related social comparison (BRSC and eating disorders (EDs by: (a comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD, and no psychiatric history; and (b investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12–18 (25 per diagnostic group. To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others’. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2, Beck Depression Inventory-II (BDI-II, and Rosenberg Self-Esteem Scale (RSE. Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001. Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01, and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.
Hamel, Andrea E; Zaitsoff, Shannon L; Taylor, Andrew; Menna, Rosanne; Le Grange, Daniel
The purpose of this study was to investigate the association between body-related social comparison (BRSC) and eating disorders (EDs) by: (a) comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD), and no psychiatric history; and (b) investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12-18 (25 per diagnostic group). To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others'. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2), Beck Depression Inventory-II (BDI-II), and Rosenberg Self-Esteem Scale (RSE). Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001). Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01), and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.
Katrin E. Giel
Full Text Available Objective: The aim of this study was to identify the prevalence of eating disorder symptoms in obese adolescents participating in a lifestyle intervention for weight loss and to investigate possible relationships with weight change, general psychopathology, and health-related quality of life (HRQOL. Method: At the beginning and after completion of a 6-month lifestyle intervention, 41 participants (20 females; age: 13.7 ± 1.4 years reported on core symptoms of eating disorders (SCOFF, self-esteem (Rosenberg Self-Esteem Scale, RSES, and HRQOL (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, KINDL, while parents filled in a questionnaire assessing their children's internalizing and externalizing behavioral problems (Child Behavior Checklist, CBCL. Results: Compared to age-matched normative samples, patients showed increased behavior problems and an impaired HRQOL. 43% of the patients were screened positive for an eating disorder pathology, and this subgroup showed an increased psychopathological burden compared to patients that were screened negative. The lifestyle intervention resulted in a significant weight loss which was unaffected by the presence of an eating disorder pathology. The screening rate for eating disorders remained stable after the intervention. Conclusion: The large overlap, mutual interaction, and high burden of eating and weight problems in children and adolescents underpin the need for an integrated view in both prevention and treatment approaches in pediatric obesity.
Giel, Katrin E; Zipfel, Stephan; Schweizer, Roland; Braun, Regina; Ranke, Michael B; Binder, Gerhard; Ehehalt, Stefan
The aim of this study was to identify the prevalence of eating disorder symptoms in obese adolescents participating in a lifestyle intervention for weight loss and to investigate possible relationships with weight change, general psychopathology, and health-related quality of life (HRQOL). At the beginning and after completion of a 6-month lifestyle intervention, 41 participants (20 females; age: 13.7 ± 1.4 years) reported on core symptoms of eating disorders (SCOFF), self-esteem (Rosenberg Self-Esteem Scale, RSES), and HRQOL (Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, KINDL), while parents filled in a questionnaire assessing their children's internalizing and externalizing behavioral problems (Child Behavior Checklist, CBCL). Compared to age-matched normative samples, patients showed increased behavior problems and an impaired HRQOL. 43% of the patients were screened positive for an eating disorder pathology, and this subgroup showed an increased psychopathological burden compared to patients that were screened negative. The lifestyle intervention resulted in a significant weight loss which was unaffected by the presence of an eating disorder pathology. The screening rate for eating disorders remained stable after the intervention. The large overlap, mutual interaction, and high burden of eating and weight problems in children and adolescents underpin the need for an integrated view in both prevention and treatment approaches in pediatric obesity.
Krug, I; Villarejo, C; Jiménez-Murcia, S; Perpiñá, C; Vilarrasa, N; Granero, R; Cebolla, A; Botella, C; Montserrat-Gil de Bernabe, M; Penelo, E; Casella, S; Islam, M A; Orekhova, E; Casanueva, F F; Karwautz, A; Menchón, J M; Treasure, J; Fernández-Aranda, F
This study aimed to examine whether there is an association between individual, social and family influences and dysfunctional eating patterns early in life and the likelihood of developing a subsequent underweight eating disorder (ED) or obesity. The total sample comprised 152 individuals (underweight ED, n = 45; obese patients, n = 65; healthy controls; n = 42) from Barcelona, Spain. The Cross-Cultural Questionnaire (CCQ) was used to assess early eating influences as well as individual and family eating patterns and attitudes towards food. Even though a few shared eating influences emerged for both groups, unique factors were also observed. Whereas relationship with friends, teasing about eating habits by family members and the mass media were of specific relevance to the underweight ED group, the patient's own physical appearance, body dissatisfaction, teasing about eating habits by friends, teasing about body shape by family members and dysfunctional eating patterns were unique to obesity. Overlapping environmental risk factors provide evidence for integral prevention and intervention approaches that simultaneously tackle a range of weight-related problems. The unique factors might be important for targeting high-risk individuals. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.
Poppe, I; Simons, A; Glazemakers, I; Van West, D
The incidence of anorexia nervosa (AN) in adolescents has increased significantly in recent years. In several studies and in the media it has been suggested that AN has recently become more prevalent in the pre-adolescence. In view of the impact that an eating disorder can have on a child, it is important to diagnose and start treating the illness as early as possible. To review the literature on the characteristics and susceptibilities of patients with eating disorders because this information can be important for early diagnosis, prevention and identification of susceptibilities to early-onset eating disorders. We searched the literature for articles relating to early-onset eating disorders. We based our search on PubMed and on related relevant articles listed in the references. We selected 34 relevant articles published between 1987 and 2014. The literature lists characteristics and susceptibilities at various levels. Many types of factors are involved; examples of 'biological' factors are prior streptococcal infection, previous consultations with GP and a patients medical history; psychological factors include comorbidity, temperament, a particular personality profile, maturation-anxiety; environmental factors such as family history, family functioning and/or stressful events can play a role in the development of eating disorders. CONCLUSION The literature indicates that the early development of AN in children is related to a complex combination of etiological factors. However, there is a need for more research into this group of patients.
Shelton, Virginia L.; Valkyrie, Karena T.
Eating disorders are compulsive behaviors that can consume a person's life to the point of becoming life threatening. Previous research found stress associated with eating disorders. College can be a stressful time. If stress predicted precursor behaviors to eating disorders, then counselors would have a better chance to help students sooner. This…
Alfoukha, Marwa M; Hamdan-Mansour, Ayman M; Banihani, Manar Ali
Prevalence of eating disorders (EDs) has increased among adolescents in Arabic and Western countries. The purposes are to identify the risk of ED and psychosocial correlates of risk of ED among high school girls in Jordan. The researchers employed a cross-sectional, correlational design using 799 high school girls from governmental and private schools in the central region of Jordan. The results indicate that prevalence of the risk of ED was 12%. The risk of ED had significant and positive correlation with body shape dissatisfaction, self-esteem, psychological distress, and pressure from family, peers, and media ( p self-esteem, negative peer pressure, and being young were significant predictors of the risk of EDs. Risk of ED is highly prevalent among high school girls, and school nurses need to adopt a model of care addressing the risk factors while caring for high school girls.
de Zwaan, M; Biener, D; Bach, M; Wiesnagrotzki, S; Stacher, G
A decreased sensitivity to painful stimuli and high scores for alexithymia and depression have been observed in patients with eating disorders. We investigated the relationship between these factors in 22 patients with anorexia nervosa, 18 patients with bulimia nervosa, and 32 healthy subjects. Alexithymia was assessed using the 20-item Toronto Alexithymia Scale and depression using the Beck Depression Inventory. Patients with bulimia exhibited significantly higher thresholds to mechanically induced pain than healthy subjects. Thresholds to thermally induced pain in patients with anorexia or bulimia were similar and significantly higher than in the healthy subjects. Alexithymia and depression scores were significantly higher in anorexic and bulimic patients than in the healthy subjects. Analyses of covariance revealed that the degree of alexithymia did not influence thresholds to thermally and mechanically induced pain, whereas the severity of depression affected to some extent the threshold to thermally induced pain.
... talk to your son or daughter about healthy-eating habits. Eating disorders are serious conditions related to persistent ... normal Expressing depression, disgust, shame or guilt about eating habits To help prevent teen eating disorders, talk to ...
Full Text Available According to International Classification of Diseases by World Health Organization, eating disorders are behavioural syndromes associated with physiological disturbances . Eating disorders include anorexia nervosa, atypical anorexia nervosa, bulimia nervosa, atypical bulimia nervosa, overeating associated with other psychological disturbances and vomiting associated with other psychological disturbances . Maladaptive eating pattern and inadequate physical activity are seen in adolescents with eating disorders and obesity . Those with comorbid eating disorder and obesity have a poorer prognosis and are at higher risk for future medical problems.
Polivy, Janet; Herman, C Peter
Anorexia nervosa and bulimia nervosa have emerged as the predominant eating disorders. We review the recent research evidence pertaining to the development of these disorders, including sociocultural factors (e.g., media and peer influences), family factors (e.g., enmeshment and criticism), negative affect, low self-esteem, and body dissatisfaction. Also reviewed are cognitive and biological aspects of eating disorders. Some contributory factors appear to be necessary for the appearance of eating disorders, but none is sufficient. Eating disorders may represent a way of coping with problems of identity and personal control.
Kravvariti, V; Gonidakis, Fr
Women suffering from eating disorders, present considerable retardation and difficulties in their psychosexual development during adolescence. This leads to primary or secondary insufficiencies in their adult sexual life. The cause of these difficulties seems to be a series of biological, family and psychosocial factors. The majority of the research findings indicate that eating disorders have a negative impact on the patient's sexual function. The factors related to eating disorders symptomatology that influence sexuality are various and differ among each eating disorder diagnostic categories. Considering anorexia nervosa, it has been reported that women have negative attitudes to sexual issues and their body. Their sexual motivation increases when they engage in psychotherapy and their body weight is gradually restored. Starvation and its consequences on the human physiology and especially on the brain function seem to be the main factor that leads to reduced sexual desire and scarce sexual activity. Moreover, personality traits that are common in patients suffering from anorexia nervosa such as compulsivity and rigidity are also related with difficulties initiating and retaining romantic and sexual relationships. Usually patients suffering from anorexia nervosa report impaired sexual behavior and lack of interest to engage in a sexual relationship. Considering Bulimia Nervosa, impulsivity and difficulties in emotion regulation that are common features of the individuals that suffer from bulimia nervosa are also related to impulsive and sometimes self-harming sexual behaviors. Moreover women sufferers often report repulsion, anger and shame towards their body and weight, mainly due to the distorted perception that they are fat and ugly. It is interesting that a number of research findings indicate that although patients suffering from bulimia nervosa are more sexually active and have more sexual experiences than patients suffering from anorexia nervosa, both
Zaina, Fabio; Donzelli, Sabrina; Lusini, Monia; Vismara, Luca; Capodaglio, Paolo; Neri, Laura; Negrini, Stefano
A recent study suggests a correlation between idiopathic scoliosis in adolescence and eating disorders. However, this does not correspond with our clinical experience in the same population. The aim of this study was to verify the correlation between scoliosis and eating disorders in adolescence. A cross-sectional study was designed including 187…
Conclusions: Treatment and prevention of ED may have broader economic benefits in terms of heath care savings and gains in work productivity than previously recognized. This exploratory study justifies large scale evaluations of the societal economic impact of eating disorders and comorbidities.
Smith, April R; Velkoff, Elizabeth A; Ribeiro, Jessica D; Franklin, Joseph
This meta-analysis addressed whether eating disorders (EDs) are risk factors (i.e., longitudinal predictors) for suicidal thoughts and behaviors. We identified 2,611 longitudinal studies published through August 1, 2017. Inclusion required studies include at least one longitudinal analysis predicting suicide ideation, attempt, or death using an ED diagnosis and/or symptom. Fourteen studies (42 prediction cases) met criteria. Results indicated that clinically diagnosed EDs and disordered eating symptoms were significant but weak predictors of suicide attempts but not death. Effects remained weak when moderators were considered. By reviewing the methodological limitations of previous research, these results highlight avenues for future research. © 2018 The American Association of Suicidology.
Kamińska, Katarzyna; Rybakowski, Filip
Eating disorders--anorexia nervosa, bulimia nervosa and eating disorders not otherwise specified (EDNOS) occur usually in young females. The significant pathogenic differences between patients who only restrict food, and patients with binge eating and compensatory behaviours, such as vomiting and purging were described. The prevalence of bipolar affective disorders--especially bipolar II and bipolar spectrum disorders (BS) may reach 5% in the general population. About half of the depressive episodes are associated with a "mild" bipolar disorder, and such a diagnosis is suggested by impulsivity and mood-instability. Previously, majority of research on the comorbidity between eating and affective disorders focused on depressive symptomatology, however difficulties in the reliable assessment of hypomania may obfuscate the estimation of the co-occurrence of eating disorders with BS. Epidemiological studies suggest the association between BS and eating disorders with binge episodes (bulimia nervosa, anorexia- bulimic type and EDNOS with binge episodes). Co-occurrence of such disorders with depressive symptoms probably suggests the diagnosis of BS, not recurrent depression. Bulimic behaviours, impulsivity and affective disorders might be related to the impairment of the serotonergic neurotransmission, which may result from the genetic vulnerability and early life trauma. Currently, the first-line pharmacological treatment of co-occurring eating disorders with binge episodes and BS are selective serotonin reuptake inhibitors. However in some cases, the use of mood-stabilising agents as monotherapy or in combination with serotonergic drugs may be helpful.
Dialectical behaviour therapy and an added cognitive behavioural treatment module for eating disorders in women with borderline personality disorder and anorexia nervosa or bulimia nervosa who failed to respond to previous treatments. An open trial with a 15-month follow-up.
Kröger, Christoph; Schweiger, Ulrich; Sipos, Valerija; Kliem, Sören; Arnold, Ruediger; Schunert, Tanja; Reinecker, Hans
There is evidence from case studies suggesting that adapted dialectical behavior therapy (DBT) for borderline personality disorder (BPD) and eating disorders (ED) might improve disorder related complaints. Twenty-four women with BPD (9 with comorbid anorexia nervosa [AN] and 15 with bulimia nervosa [BN]), who already had failed to respond to previous eating-disorder related inpatient treatments were consecutively admitted to an adapted inpatient DBT program. Assessment points were at pre-treatment, post-treatment, and 15-month follow-up. At follow-up, the remission rate was 54% for BN, and 33% for AN. Yet 44% of women with AN crossed over to BN and one woman additionally met the criteria of AN. For women with AN, the mean weight was not significantly increased at post-treatment, but had improved at follow-up. For women with BN, the frequency of binge-eating episodes was reduced at post-treatment as well as at follow-up. Self-rated eating-related complaints and general psychopathology, as well as ratings on global psychosocial functioning, were significantly improved at post-treatment and at follow-up. Although these findings support the assumption that the adapted DBT inpatient program is a potentially efficacious treatment for those who failed to respond to previous eating-disorder related inpatient treatments, remission rates and maintained eating-related psychopathology also suggest that this treatment needs further improvement. 2010 Elsevier Ltd. All rights reserved.
Montebarocci, O; Codispoti, M; Surcinelli, P; Franzoni, E; Baldaro, B; Rossi, N
Previous studies indicate that patients with eating disorders have alexithymic characteristics, as revealed by the Toronto Alexithymia Scale (TAS). The aim of the present study was to investigate the role of negative affect (anxiety and depression) in the relationship between eating disorders and alexithymia. In addition, we have evaluated whether the relationship between negative affect and alexithymia varies according to the type of eating disorder (anorexia and bulimia). Eighteen female patients and 16 female patients who met the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) diagnostic criteria for restrictive anorexia nervosa and bulimia nervosa, respectively, and 18 healthy female controls matched by age and education were submitted to Beck Depression Inventory and Spielberger State-Trait Anxiety Inventory to assess depression and anxiety and the Toronto Alexithymia Scale (TAS-20) and the Bermond Vorst Alexithymia Questionnaire (BVAQ) to evaluate alexithymic characteristics. The findings indicated that, although anorexic and bulimic patients showed higher alexithymia scores compared to controls, this result could be mainly related to negative affect. In fact, taking negative affect into account, anorexic and bulimic patients did not show higher TAS-20 and BVAQ scores compared to controls. The only variable useful to discriminate among anorexics, bulimics and controls is the perceived inability to experience emotional feelings, which is higher in anorexic patients compared to the other two groups.
Pilecki, Maciej; Józefik, Barbara; Kościelniak, Marta
Analysis of the correlation between the assessment of current family relations in families of patients diagnosed with eating disorders and the assessment of the relations in the family of origin of their parents. 54 female patients with restrictive anorexia nervosa, 22 female patients with binge-purge anorexia, 36 female patients with bulimia. Two control groups were included: 36 female patients with depressive disorders and 85 schoolgirls from Krakow. The study also covered the girls' parents. Family of Origin Scale and FAM Family Assessment Measure (Polish version). In the families of schoolgirls from Krakow better evaluation of the experience of intimacy and autonomy in the family of origin of parents of the investigated girls was associated with their and their children more favourable perception of relations in the present nuclear family. What proved particularly significant were perception of transgenerational experiences of the fathers. Only a few statistically significant correlations were observed in all clinical groups. In the parents of the investigated patients a weak correlation was observed between the current marital relations perception and transgenerational experiences evaluation and a significant correlation between parents' transgenerational experience evaluation and the assessment of the relations with their daughters. No specific correlations were found between the perception of the transgenerational experience of parents and evaluation of current relations in the nuclear family of their children with eating disorders. The results in the group with eating disorders suggest that the relations between parents and daughters are more intense than marital relations.
Strandskov, Sandra Weineland; Ghaderi, Ata; Andersson, Hedvig; Parmskog, Nicole; Hjort, Emelie; Wärn, Anna Svanberg; Jannert, Maria; Andersson, Gerhard
This is the first trial to investigate the outcome of tailored and ACT-influenced, cognitive behavioral Internet treatment for eating disorder psychopathology, and the relation between knowledge acquisition and outcome. This study utilized a randomized controlled design, with computer-based allocation to treatment or waiting list control group. Participants were recruited via advertisements in social media and newspapers in Sweden. Participants fulfilling the criteria for bulimia nervosa (BN), or Eating Disorder Not Otherwise Specified (EDNOS), with a BMI above 17.5, were enrolled in the study (N = 92). The treatment group received an Internet-based, ACT-influenced CBT intervention, developed by the authors, for eating disorders. The treatment lasted 8 weeks, and was adapted to the participant's individual needs. A clinician provided support. The main outcome measures were eating disorder symptoms and body shape dissatisfaction. Intent-to-treat analysis showed that the treatment group (n = 46) improved significantly on eating disorder symptoms and body dissatisfaction, compared with the waiting list control group (n = 46), with small to moderate effect sizes (between group effects, d = 0.35-0.64). More than a third of the participants in the treatment group (36.6%), compared to 7.1% in the waiting list control condition, made clinically significant improvements. Results showed a significant increase in knowledge in the treatment group compared to the waiting list control group (between group effect, d = 1.12), but we found no significant correlations between knowledge acquisition and outcome (r= -0.27 to -r = 0.23). The results provide preliminary support for Internet-based, tailored, and ACT-influenced treatment, based on CBT for participants with eating disorder psychopathology. Copyright © 2017. Published by Elsevier Ltd.
Eliot, Alexandra O.; Baker, Christina Wood
Described a sample of eating disordered adolescent males who were seen for treatment at Boston Children's Hospital Outpatient Eating Disorders Clinic. Findings suggest the idea that clinicians, coaches, peers, and family should encourage young men to share concerns about body image and weight at an earlier, less severe juncture, with the assurance…
Although commonly associated with girls and women, eating disorders do not discriminate. School nurses need to be aware that male students also can suffer from the serious health effects of anorexia nervosa, bulimia, anorexia athletica, and eating disorders not otherwise specified. Sports that focus on leanness and weight limits can add to a…
... us in our mission. F.E.A.S.T.'s Eating Disorders Glossary Welcome to our comprehensive quick-reference eating ... Conversion Weight Manipulation Weight restoration, weight restored Zinc Eating disorders biology & pharmacology Antidepressants BDNF - brain-derived neurotophic factor ...
Slof-Op 't Landt, Margarita Cornelia Theodora
In this thesis, a series of studies on different aspects of the genetics of eating disorders is presented. The heritability of disordered eating behavior and attitudes in relation with body mass index (BMI) was evaluated in a large adolescent twin-family sample ascertained through the Netherlands
Davis, Caroline; Mackew, Laura; Levitan, Robert D; Kaplan, Allan S; Carter, Jacqueline C; Kennedy, James L
While there is good evidence that binge eating disorder (BED) is linked to higher-than-expected use of a broad range of addictive behaviors, mechanisms underlying this association are not well understood. Using a mediation-analytical approach with three age- and gender-matched groups - overweight/obese adults with ( n = 42) and without ( n = 104) BED, and normal-weight control participants ( n = 73) - we tested the hypothesis that adults with BED would engage in more addictive behaviors and have higher scores on a personality-risk index than the two control groups. We also anticipated that the relationship between BED and addictive behaviors would be mediated by a high-risk personality profile. The predicted mediation effect was strongly supported. Contrary to expectation, BED participants did not engage in more addictive behaviors or have higher personality-risk scores than their weight-matched counterparts. However, both overweight/obese groups did have significantly higher scores than the normal-weight group. The relationships among personality risk, elevated body mass index (BMI), and addictive behaviors have important clinical implications, especially for treatments that target psycho-behavioral intervention for compulsive overeating and substance-use disorders.
Full Text Available While there is good evidence that binge eating disorder (BED is linked to higher-than-expected use of a broad range of addictive behaviors, mechanisms underlying this association are not well understood. Using a mediation-analytical approach with three age- and gender-matched groups – overweight/obese adults with (n = 42 and without (n = 104 BED, and normal-weight control participants (n = 73 – we tested the hypothesis that adults with BED would engage in more addictive behaviors and have higher scores on a personality-risk index than the two control groups. We also anticipated that the relationship between BED and addictive behaviors would be mediated by a high-risk personality profile. The predicted mediation effect was strongly supported. Contrary to expectation, BED participants did not engage in more addictive behaviors or have higher personality-risk scores than their weight-matched counterparts. However, both overweight/obese groups did have significantly higher scores than the normal-weight group. The relationships among personality risk, elevated body mass index (BMI, and addictive behaviors have important clinical implications, especially for treatments that target psycho-behavioral intervention for compulsive overeating and substance-use disorders.
Muñoz, P; Quintana, J M; Las Hayas, C; Aguirre, U; Padierna, A; González-Torres, M A
To evaluate and compare the quality of life (QOL) in patients with eating disorders (ED) and general population, using the disease-specific Health-Related Quality of Life for Eating Disorders (HeRQoLED) questionnaire. A total of 358 patients with ED completed the HeRQoLED questionnaire as well as the SF-12 and the Eating Attitudes Test (EAT-26) at baseline; 273 patients completed the same instruments after 1 year of multidisciplinary treatment. A total of 305 individuals recruited from the general population completed the HeRQoLED once. Comparison of means was used to assess change. Multivariate models were created to determine variables predictive of change in HeRQoLED scores. Patients with anorexia nervosa had higher baseline scores (indicating worse perception of QOL) on the HeRQoLED questionnaire and experienced smaller improvements than patients with other diagnoses after 1 year of treatment. After adjustment by relevant variables, body-mass index (BMI) and EAT-26 scores were associated with changes in QOL. SF-12 scores showed significant improvement in the physical health component but not in mental health. General population had lower baseline scores on the HeRQoLED. As measured by the disease-specific HeRQoLED and generic instruments, QOL in patients with ED improved after 1 year of treatment, though it did not reach the values of the general population.
Mora, Marisol; Penelo, Eva; Rosés, Rocío; González, Marcela L; Espinoza, Paola; Deví, Josep; Raich, Rosa M
As eating disorders have severe consequences, they require prevention. We aimed to compare maladaptive beliefs related to eating disorders by following two programs based on media literacy in adolescents at post-test intervention, and after 6 and 12month-follow-ups. The Male and Female Nutrition and Media Literacy Model preventive program (NUT+MEF+MEM+ML in Spanish) and the Theater Alive program are both based on the same contents, the former being presented in a multimedia and interactive format and the latter in a drama format. Both were compared to a control group without intervention, whose participants received usual classes before the assessments. Participants were 178 adolescents in the second year of compulsory secondary education from fours schools of Terrassa (Catalonia, Spain). All participants in each school were assigned to the same group, depending on school schedules. A mixed 3 (group: Theater Alive, NUT+MEF+MEM+ML, control)×3 (time: post-test, 6-month-follow-up, 12-month-follow-up) factorial design was used to evaluate the effect on maladaptive beliefs measured using a CE-TCA tool. When compared to the control group, both Theater Alive (d=0.88) and NUT+MEM+MEF+ML (d=0.60) obtained lower scores over time, the latter being not statistically significant. The Theater Alive program may produce an effect of cognitive dissonance that might eliminate the discrepancy between the contents of the play and those that are internalized, thus modifying maladaptive beliefs. Participants in the Theater Alive program, as actors in front of an audience, had to defend certain content that was rehearsed over and over again to the point until it became internalized. Copyright © 2016 Elsevier Ltd. All rights reserved.
Kuipers, Greet S.; Van Loenhout, Zara; Van Der Ark, L. Andries; Bekker, M.H.J.
In a sample of 38 eating disorder (ED) patients who received psychotherapeutic treatment, changes in attachment security, and mentalization in relation to symptoms reduction were investigated. Attachment security improved in 1 year but was unrelated to improvement of ED or comorbid symptoms.
Kuipers, G.S.; den Hollanders, S.; van der Ark, L.A.; Bekker, M.H.J.
Purpose To investigate whether recovery from an eating disorder is related to pre-treatment attachment and mentalization and/or to improvement of attachment and mentalization during treatment. Method For a sample of 38 anorexia nervosa (AN) and bulimia nervosa (BN) patients receiving treatment the
Kuipers, G. S.; den Hollander, S.; van der Ark, L.A.; Bekker, M.H.J.
Purpose To investigate whether recovery from an eating disorder is related to pre-treatment attachment and mentalization and/or to improvement of attachment and mentalization during treatment. Method For a sample of 38 anorexia nervosa (AN) and bulimia nervosa (BN) patients receiving treatment the
Klump, Kelly L; Strober, Michael; Bulik, Cynthia M; Thornton, Laura; Johnson, Craig; Devlin, Bernie; Fichter, Manfred M; Halmi, Katherine A; Kaplan, Allan S; Woodside, D Blake; Crow, Scott; Mitchell, James; Rotondo, Alessandro; Keel, Pamela K; Berrettini, Wade H; Plotnicov, Katherine; Pollice, Christine; Lilenfeld, Lisa R; Kaye, Walter H
Previous studies of personality characteristics in women with eating disorders primarily have focused on women who are acutely ill. This study compares personality characteristics among women who are ill with eating disorders, recovered from eating disorders, and those without eating or other Axis I disorder pathology. Female participants were assessed for personality characteristics using the Temperament and Character Inventory (TCI): 122 with anorexia nervosa (AN; 77 ill, 45 recovered), 279 with bulimia nervosa (BN; 194 ill, 85 recovered), 267 with lifetime histories of both anorexia and bulimia nervosa (AN + BN; 194 ill, 73 recovered), 63 with eating disorder not otherwise specified (EDNOS; 31 ill, 32 recovered), and 507 without eating or Axis I disorder pathology. Women ill with all types of eating disorders exhibited several TCI score differences from control women, particularly in the areas of novelty-seeking, harm avoidance, self-directedness, and cooperativeness. Interestingly, women recovered from eating disorders reported higher levels of harm avoidance and lower self-directedness and cooperativeness scores than did normal control women. Women with eating disorders in both the ill and recovered state show higher levels of harm avoidance and lower self-directedness and cooperativeness scores than normal control women. Although findings suggest that disturbances may be trait-related and contribute to the disorders' pathogenesis, additional research with more representative community controls, rather than our pre-screened, normal controls, is needed to confirm these impressions.
Lipson, S K; Sonneville, K R
We sought to estimate the prevalence of eating disorder symptoms in a large sample of U.S. college students and variations therein across student characteristics. Participants were 9713 students from 12 colleges and universities participating in the Healthy Bodies Study. We used gender-stratified logistic regression to estimate bivariate correlates of elevated eating disorder symptoms, past-month objective binge eating, and past-month compensatory behaviors across student characteristics including age, degree-level, sexual orientation, race/ethnicity, first-generation status, citizenship, academic and extracurricular characteristics, and weight status. Eating disorder outcomes were based on the Eating Disorder Examination Questionnaire. We observed higher prevalence of objective binge eating among females relative to males (49% versus 30%, pobesity. When compared to individuals with a healthy weight, those with overweight had greater eating disorder risk (males OR=3.5; females OR=2.0), binge eating (males OR=2.1; females OR=1.9), and use of compensatory behaviors (males OR=1.5; females OR=1.3). This study suggests smaller gender difference in prevalence of eating disorder symptoms than previously reported and identifies students with overweight/obesity as salient targets for campus-based eating disorder screening and early intervention efforts. Copyright © 2016 Elsevier Ltd. All rights reserved.
Early diagnosis and treatment are important for the prognosis in eating disorders and will also reduce the burden on the patient as well as n his or her family. On the other hand, community studies show that less than half of clinical cases of eating disorders are identified in primary care; hence, better skills among general practitioners in this field are very important. On the basis of the literature and clinical experience, this article discusses various problems related to identifying, evaluating and treating patients with eating disorders in primary care. The most important tool for the general practitioner is an understanding of the nature of the disorder, but tools for identification and treatment are also useful. Attending the patient and collaboration with hospitals and outpatient clinics could be a challenge. There are guidelines for the treatment of eating disorders in specialised health care, including indications for hospitalisation, but no guidelines for referral to outpatient treatment or for the coordination between the general practitioner and specialised units. The proposed British guidelines might serve as a basis for Norwegian guidelines.
Wisting, Line; Bang, Lasse; Skrivarhaug, Torild; Dahl-J?rgensen, Knut; R?, ?yvind
Objective To investigate correlates of eating disorder psychopathology in adolescent males and females with type 1 diabetes. Method A total of 105 adolescents with type 1 diabetes (42% males), aged 12?20 years, were recruited from the Norwegian Childhood Diabetes Registry in this population-based study. All participants were interviewed with the Child Eating Disorder Examination. Additionally, the Brief Illness Perception Questionnaire, the Adolescent Coping Orientation for Problem Experience...
Rieger, Elizabeth; Palermo, Romina; Byrne, Susan; Bell, Jason
The present study sought to investigate the association between selective attentional processing of body images, rumination, and eating disorder symptoms in young women. Seventy-three undergraduate female students (ages 17–24) completed a modified dot-probe task to assess whether young women showed a differential attentional bias pattern towards thin and non-thin female bodies. Participants also completed self-report measures of eating disorder pathology. It was found that increased reports of dietary restraint and body dissatisfaction were associated with both greater attentional bias towards thin bodies and avoidance of non-thin bodies (as compared to neutral images), although the former relationship was stronger than the latter. The results suggest attentional vigilance to thin-ideal images plays a greater role in the potential development and/or maintenance of eating disorder symptoms, at least in a university sample of young women. Results also revealed that eating disorder-specific rumination mediated the relationship between attentional bias to thin ideal images and eating disorder symptoms. These findings build on existing research and theories, for example the impaired disengagement model of rumination, and have potential clinical applications such as specifically targeting ruminative and/or attentional processes in the prevention and/or treatment of eating disorder symptoms. PMID:28542431
Dondzilo, Laura; Rieger, Elizabeth; Palermo, Romina; Byrne, Susan; Bell, Jason
The present study sought to investigate the association between selective attentional processing of body images, rumination, and eating disorder symptoms in young women. Seventy-three undergraduate female students (ages 17-24) completed a modified dot-probe task to assess whether young women showed a differential attentional bias pattern towards thin and non-thin female bodies. Participants also completed self-report measures of eating disorder pathology. It was found that increased reports of dietary restraint and body dissatisfaction were associated with both greater attentional bias towards thin bodies and avoidance of non-thin bodies (as compared to neutral images), although the former relationship was stronger than the latter. The results suggest attentional vigilance to thin-ideal images plays a greater role in the potential development and/or maintenance of eating disorder symptoms, at least in a university sample of young women. Results also revealed that eating disorder-specific rumination mediated the relationship between attentional bias to thin ideal images and eating disorder symptoms. These findings build on existing research and theories, for example the impaired disengagement model of rumination, and have potential clinical applications such as specifically targeting ruminative and/or attentional processes in the prevention and/or treatment of eating disorder symptoms.
Full Text Available The present study sought to investigate the association between selective attentional processing of body images, rumination, and eating disorder symptoms in young women. Seventy-three undergraduate female students (ages 17-24 completed a modified dot-probe task to assess whether young women showed a differential attentional bias pattern towards thin and non-thin female bodies. Participants also completed self-report measures of eating disorder pathology. It was found that increased reports of dietary restraint and body dissatisfaction were associated with both greater attentional bias towards thin bodies and avoidance of non-thin bodies (as compared to neutral images, although the former relationship was stronger than the latter. The results suggest attentional vigilance to thin-ideal images plays a greater role in the potential development and/or maintenance of eating disorder symptoms, at least in a university sample of young women. Results also revealed that eating disorder-specific rumination mediated the relationship between attentional bias to thin ideal images and eating disorder symptoms. These findings build on existing research and theories, for example the impaired disengagement model of rumination, and have potential clinical applications such as specifically targeting ruminative and/or attentional processes in the prevention and/or treatment of eating disorder symptoms.
Gillett, Kyle S.; Harper, James M.; Larson, Jeffry H.; Berrett, Michael E.; Hardman, Randy K.
Family environment has been shown to be one of the factors related to the presence of eating disorders among young-adult females. Clinical experience and theories about eating disorders postulate that implicit family rules are an intricate part of family process that may have a great effect on the creation and maintenance of such problems. This…
Gonçalves, Juliana de Abreu; Moreira, Emilia Addison M; Trindade, Erasmo Benício S de M; Fiates, Giovanna Medeiros R
To discuss eating disorders in children and adolescents regarding their characteristics and risk factors. Articles were searched in the PubMed and ScieLO databases, combining the terms 'children', 'adolescents', 'eating behavior', 'eating disorder', 'bulimia', and 'anorexia', both in Portuguese and in English. Studies published between 2007 and 2011 were retrieved and 49 articles that assessed eating behavior and disorders, nervous anorexia and bulimia, and non-specific eating disorders were selected. Eating disorders, especially non-specific ones, were common during childhood and adolescence. The presence of such disorders was attributed mainly to family environment and exposure to the media. Eating disorders were frequently followed by psychological comorbidities. Among the risk factors for eating disorders, social and family environment and the media were the most important ones. The influence of the media and social environment has been related to the worship of thinness. As to family environment, mealtimes appeared to be fundamental in shaping eating behavior and the development of disorders. Eating disorders were associated with nutritional problems (growing impairment and weight gain), oral health (cheilitis, dental erosion, periodontitis, and hypertrophy of salivary glands), and social prejudice.
Hay, Phillipa; Mitchison, Deborah; Collado, Abraham Ernesto Lopez; González-Chica, David Alejandro; Stocks, Nigel; Touyz, Stephen
Little is known about the epidemiology and health related quality of life (HRQoL) of the new DSM-5 diagnoses, Binge Eating Disorder (BED) and Avoidant/Restrictive Food Intake Disorder (ARFID) in the Australian population. We aimed to investigate the prevalance and burden of these disorders. We conducted two sequential population-based surveys including individuals aged over 15 years who were interviewed in 2014 ( n = 2732) and 2015 ( n =3005). Demographic information and diagnostic features of DSM-5 eating disorders were asked including the occurrence of regular (at least weekly over the past 3 months) objective binge eating with levels of distress, extreme dietary restriction/fasting for weight/shape control, purging behaviors, overvaluation of shape and/or weight, and the presence of an avoidant/restrictive food intake without overvaluation of shape and/or weight. In 2014 functional impact or role performance was measured with the 'days out of role' question and in 2015, Health Related Quality of Life (HRQoL) was assessed with the Short Form -12 item questionnaire (SF-12v1). The 2014 and 2015 3-month prevalence of eating disorders were: anorexia nervosa-broad 0.4% (95% CI 0.2-0.7) and 0.5% (0.3-0.9); bulimia nervosa 1.1% (0.7-1.5) and 1.2% (0.9-1.7); ARFID 0.3% (0.1-0.5) and 0.3% (0.2-0.6). The 2015 3-month prevalence rates were: BED-broad 1.5% (1.1-2.0); Other Specified Feeding or Eating Disorder (OSFED) 3.2 (2.6-3.9); and Unspecified Feeding or Eating Disorder (UFED) 10.4% (0.9-11.5). Most people with OSFED had atypical anorexia nervosa and majority with UFED were characterised by having recurrent binge eating without marked distress. Eating disorders were represented throughout sociodemographic groups and those with bulimia nervosa and BED-broad had mean weight (BMI, kg/m 2 ) in the obese range. Mental HRQoL was poor in all eating disorder groups but particularly poor for those with BED-broad and ARFID. Individuals with bulimia nervosa, BED
Eating disorders are serious psychiatric conditions often demanding specialized psychiatric care. Several effective treatments have been developed and disseminated, but more needs to be done, as not all patients respond well to intervention, let alone achieve recovery. Obvious candidates such as eating disorder diagnosis, symptoms and psychiatric comorbidity have generally failed to explain variability in prognosis and outcome, warranting investigation of a wider range of relevant factors. Ac...
Halmi, Katherine A
Treatment resistance is an omnipresent frustration in eating disorders. Attempts to identify the features of this resistance and subsequently develop novel treatments have had modest effects. This selective review examines treatment resistant features expressed in core eating disorder psychopathology, comorbidities and biological features. Novel treatments addressing resistance are discussed. The core eating disorder psychopathology of anorexia nervosa becomes a coping mechanism likely via vulnerable neurobiological features and conditioned learning to deal with life events. Thus it is reinforcing and ego syntonic resulting in resistance to treatment. The severity of core features such as preoccupations with body image, weight, eating and exercising predicts greater resistance to treatment. Bulimia nervosa patients are less resistant to treatment with treatment failure related to greater body image concerns, impulsivity, depression, severe diet restriction and poor social adjustment. For those with binge eating disorder overweight in childhood and high emotional eating predicts treatment resistance. There is suggestive data that a diagnosis of an anxiety disorder and severe perfectionism may confer treatment resistance in anorexia nervosa and substance use disorders or personality disorders with impulse control problems may produce resistance to treatment in bulimia nervosa. Traits such as perfectionism, cognitive inflexibility and negative affect with likely genetic influences may also affect treatment resistance. Pharmacotherapy and novel therapies have been developed to address treatment resistance. Atypical antipsychotic drugs have shown some effect in treatment resistant anorexia nervosa and topiramate and high doses of SSRIs are helpful for treatment of resistant binge eating disorder patients. There are insufficient randomized controlled trials to evaluate the novel psychotherapies which are primarily based on the core psychopathological features of the
Pisetsky, Emily M; Thornton, Laura M; Lichtenstein, Paul; Pedersen, Nancy L; Bulik, Cynthia M
We evaluated whether the prevalence of lifetime suicide attempts/completions was higher in women with a lifetime history of an eating disorder than in women with no eating disorder and assessed whether eating disorder features, comorbid psychopathology, and personality characteristics were associated with suicide attempts in women with anorexia nervosa, restricting subtype (ANR), anorexia nervosa, binge-purge subtype (ANBP), lifetime history of both anorexia nervosa and bulimia nervosa (ANBN), bulimia nervosa (BN), binge eating disorder (BED), and purging disorder (PD). Participants were part of the Swedish Twin study of Adults: Genes and Environment (N = 13,035) cohort. Lifetime suicide attempts were identified using diagnoses from the Swedish National Patient and Cause of Death Registers. General linear models were applied to evaluate whether eating disorder category (ANR, ANBP, ANBN, BN, BED, PD, or no eating disorder [no ED]) was associated with suicide attempts and to identify factors associated with suicide attempts. Relative to women with no ED, lifetime suicide attempts were significantly more common in women with all types of eating disorder. None of the eating disorder features or personality variables was significantly associated with suicide attempts. In the ANBP and ANBN groups, the prevalence of comorbid psychiatric conditions was higher in individuals with than without a lifetime suicide attempt. The odds of suicide were highest in presentations that included purging behavior (ANBN, ANBN, BN, and PD), but were elevated in all eating disorders. To improve outcomes and decrease mortality, it is critical to be vigilant for suicide and identify indices for those who are at greatest risk. PsycINFO Database Record (c) 2013 APA, all rights reserved.
Mason, Tyler B; Lavender, Jason M; Wonderlich, Stephen A; Crosby, Ross D; Engel, Scott G; Mitchell, James E; Crow, Scott J; Le Grange, Daniel; Peterson, Carol B
Appearance-related stress may result from appearance-focused events such as seeing one's reflection, seeing media images, and shopping for clothes. The purpose of this study was to examine the prospective association between momentary appearance-related stress and eating disorder (ED) behaviors (i.e., binge eating and vomiting) among women with anorexia nervosa (AN) using ecological momentary assessment (EMA). We hypothesized that appearance-related stress at Time 1 would predict binge eating and vomiting at Time 2, and that this prospective association would be mediated by momentary anxiety at Time 2 (controlling for anxiety at Time 1). Women with AN completed a 2-week EMA protocol involving repeated daily assessments of experiences and behaviors. Momentary appearance-related stress preceded binge eating and vomiting, and momentary anxiety mediated the prospective association between appearance-related stress and ED behaviors. Targeted momentary interventions delivered in the natural environment that address appearance-related stress may have utility in the treatment of ED behaviors.
Deborde, A S; Berthoz, S; Godart, N; Perdereau, F; Corcos, M; Jeammet, P
Alexithymia and anhedonia both refer to a deficit in emotion regulation. Although these 2 concepts have been conceptualized to be closely linked, very few studies aimed at examining carefully their interrelations. Therefore, the purpose of the present study was to investigate the relationships between scores on alexithymia and anhedonia self-reports, and to assess whether the results were influenced by the presence of an emotional disorder. The 20-item Toronto Alexithymia Scale is the self-report most frequently used to assess alexithymia. Nevertheless, the results of recent studies comparing the psychometric properties of the TAS-20 and another alexithymia self-report - the Bermond-Vorst Alexithymia Questionnaire (BVAQ) - have recommended the BVAQ over the TAS-20. Thus, both questionnaires were included in the present study. In addition, since depression and anxiety may influence the correlations between alexithymia and anhedonia scores, we also measured depression and anxiety and these scores were used to control for their potential confounding effect in the analyses. Two groups of participants were included in this study: 46 eating disordered female patients (ED) and 198 female control subjects. All the participants filled up the Bermond-Vorst Alexithymia Questionnaire-form B (BVAQ-B), the 20-item Toronto Alexithymia Scale (TAS-20), the Chapman and Chapman Social Anhedonia Scale (SAS) and Physical Anhedonia Scale (PAS), the 13-item Beck Depression Inventory (BDI) and the Spielberger State and Trait Anxiety Inventory (STAI-Y). The analyses consisted, first, in establishing the matrix of correlations between these self-reports total scores, using Pearson's coefficients of correlation. Then, TAS-20, BVAQ-B, SAS and PAS scores were correlated, adjusting for BDI and STAI scores, using partial correlation analyses. Mean scores comparisons according to the group of participants, and to the presence/absence of alexithymia, as well as to the presence/absence of anhedonia
... cause serious health problems related to inadequate nutrition, overeating, bingeing and other factors. The type of health problems caused by eating disorders depends on the type and severity of the ...
Wagner, Allison F; Stefano, Emily C; Cicero, David C; Latner, Janet D; Mond, Jonathan M
This study examined whether gender moderates the associations between eating disorder features and quality-of-life impairment and whether eating disorder features can explain gender differences in quality of life in a sample of undergraduate students. The SF-12 Physical and Mental Component Summary Scales were used to measure health-related quality of life (HRQoL), and the Eating Disorders Examination Questionnaire (EDE-Q) was used to quantify eating disorder behaviors and cognitions. These self-report forms were completed by undergraduate men and women (n = 709). Gender was a significant predictor of mental HRQoL, such that women in this sample reported poorer mental HRQoL than men. Eating disorder cognitions were the strongest predictor of undergraduate students' mental and physical HRQoL, while binge eating negatively predicted their physical HRQoL only. Gender was not found to moderate the associations between eating disorder features and HRQoL, and eating disorder cognitions were found to mediate the association between gender and mental HRQoL such that a proportion of the difference between undergraduate men and women's mental HRQoL was attributable to eating disorder cognitions. This study provided further evidence of the significant impact of eating disorder features, particularly eating disorder cognitions, on HRQoL. The finding that gender did not moderate the relationships between eating disorder features and HRQoL indicates the importance of investigating these features in both men and women in future research.
Gabriel, C.; Waller, G.
Patients with eating disorder have relatively high rates of comorbid personality disorder diagnoses, including both anxiety-based personality disorders (obsessive-compulsive and avoidant) and borderline personality disorder. However, there is preliminary evidence that the core cognitions underlying personality pathology in the eating disorders are those related specifically to anxiety. This article builds on that evidence, replicating and extending the findings with a large sample of patients...
Arzu Onal Sonmez
Full Text Available Eating disorders are relatively common and serious disorders in adolescent and pre-adolescent age. The aim of this review is to update new findings related with mostly seen feeding and eating disorders in child and adolescents. The article focuses specifically on anorexia nervosa and bulimia nervosa. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2017; 9(3.000: 301-316
Cardi, Valentina; Tchanturia, Kate; Treasure, Janet
Social difficulties in eating disorders can manifest as predisposing traits and premorbid difficulties, and/or as consequences of the illness. Objective The aim of this paper is to briefly review the evidence for social problems in people with eating disorders and to consider the literature on treatments that target these features. Method A narrative review of the literature was conducted. Results People with eating disorders often manifest traits, such as shyness, increased tendency to submissiveness and social comparison, and problems with peer relationships before illness onset. Further social difficulties occur as the illness develops, including impaired social cognition and increased threat sensitivity. All relationships with family, peers and therapists are compromised by these effects. Thus, social difficulties are both risk and maintaining factors of eating disorders and are suitable targets for interventions. Several forms of generic treatments (e.g. interpersonal psychotherapy, cognitive analytic therapy, focal psychodynamic therapy) have an interpersonal focus and show some efficacy. Guided self-management based on the cognitive interpersonal model of the illness and directed to both individuals and support persons have been found to improve outcomes for all parties. Adjunctive treatments that focus on specific social difficulties, such as Cognitive Remediation and Emotion Skills Training and Cognitive Bias Modification have been shown to have promise. Conclusion More work is needed to establish whether these approaches can improve on the rather disappointing outcomes that are attained by currently used treatments for eating disorders. Copyright© Bentham Science Publishers; For any queries, please email at email@example.com.
Tsai, Mei-Rong; Chang, Yu-Jhen; Lien, Pei-Ju; Wong, Yueching
The purpose of this study was to investigate body weight satisfaction, eating attitudes and dietary intake related to eating disorders of female junior high school students in Taiwan. In a cross-sectional survey, 835 female junior high school students participated in this study. The questionnaire items included respondents' demographic information as well as weight and body image concerns. Developmental and attitudinal scales such as the body shape-related teasing scale, Pubertal Development Scale, Eating Attitudes Test-26 (EAT-26) and 24-hour dietary recall were also used to collect data. Data were analyzed using a Student's t test, chi-square test and logistic regression. Disturbed eating attitudes and behaviors were found in 10.4 % of participants (measured by EAT-26?20). The multivariate logistic regressions showed that disturbed eating attitudes and behaviors were associated with weight/shape-related teasing experiences and dissatisfaction with body weight. The reported intakes of energy, protein, fat, carbohydrate, cholesterol, zinc and vitamins B-6, B-12, were significantly lower in participants with disturbed eating patterns than in participants without disturbed eating. Conversely, participants with disturbed eating patterns had higher dietary and crude fiber intake than participates without disturbed eating. Disturbed eating behaviors exist among female adolescents in Taiwan, and these behaviors jeopardize their necessary dietary intake requirements. More research using the EAT-26 as a measure to predict the quality and quantity of food intake among female adolescents warrants further study.
Tasca, Giorgio A
Prominent models of eating disorders tend to focus on cognitive and behavioral features, but tend not to consider important developmental issues related to affect regulation, interpersonal style, self concept, and mentalization-all of which are well conceptualized within attachment theory. Higher levels of attachment insecurity across diagnoses are related to greater eating disorder symptoms. Low parental care and early trauma may lead to attachment insecurity that then might lead to greater eating disorder symptoms. The association between insecure attachment and eating disorder severity is likely mediated by affect dysregulation and perfectionism. Recent research using the Adult Attachment Interview highlights the importance of reflective functioning in predicting treatment response and therapeutic processes, and on the utility of therapies that increase mentalization. Copyright © 2018 Elsevier Ltd. All rights reserved.
Adolescence means an increased risk for eating disorders (ED) and the female gender is the most important risk factor. Empirical studies of the perceptions of gender ideals—as potential mediating factors between the socio-cultural context and ED—were this thesis’ primary goals. Further aims implied evaluating the psychometric properties of the Eating Disorders Inventory for Children (EDI-C) and providing normative data for boys and girls concerning self-assessed ED symptoms and related psycho...
El Ghoch, Marwan; Milanese, Chiara; Calugi, Simona; Pellegrini, Massimo; Battistini, Nino Carlo; Dalle Grave, Riccardo
Although the effect of immediate weight restoration on body composition and body fat distribution has previously been studied in anorexia nervosa (AN), its influence in women with AN on eating disorder psychopathology and psychological distress has not previously been investigated to our knowledge. We assessed body composition and fat mass distribution before and after body weight restoration and investigated any relation between changes in body fat patterns of patients with AN treated in a specialist inpatient unit and their eating disorder and psychological distress features. Body composition was measured by using dual-energy X-ray absorptiometry in 50 female, adult patients with AN before and after complete weight restoration [body mass index (BMI; in kg/m²) ≥18.5] and 100 healthy control subjects matched by age and posttreatment BMI of study group participants. Eating disorder psychopathology and psychological distress were assessed in the AN group before and after weight restoration by using the Eating Disorder Examination interview and the Global Severity Index of the Brief Symptom Inventory (BSI-GSI), respectively. After the achievement of complete weight restoration, patients with AN had higher trunk (P eating disorder psychopathology in the AN group, and the only significant predictor of change in BSI-GSI was the baseline BSI-GSI score. The normalization of body weight in patients with AN is associated with a preferential distribution of body fat in central regions, which does not, however, seem to influence either eating disorder psychopathology or psychological distress scores.
Michalska, Aneta; Szejko, Natalia; Jakubczyk, Andrzej; Wojnar, Marcin
The aim of this paper was to characterise nonspecific eating disorders (other than anorexia nervosa and bulimia nervosa). The Medline database was searched for articles on nonspecific eating disorders. The following disorders were described: binge eating disorder (BED), pica, rumination disorder, avoidant/restrictive food intake disorder, night eating syndrome (NES), sleep-related eating disorder (SRED), bigorexia, orthorexia, focusing on diagnosis, symptoms, assessment, comorbidities, clinical implications and treatment. All of the included disorders may have dangerous consequences, both somatic and psychological. They are often comorbid with other psychiatric disorders. Approximately a few percent of general population can be diagnosed with each disorder, from 0.5-4.7% (SRED) to about 7% (orthorexia). With the growing literature on the subject and changes in DSM-5, clinicians recognise and treat those disorders more often. More studies have to be conducted in order to differentiate disorders and treat or prevent them appropriately.
Selma Bozkurt Zincir
Full Text Available There are three basic pillars for the development of eating disorders: genetic predisposition, neuro-endocrine-molecular changes in the brain and metabolic response to it. As a result of neuroendocrine research, a close relationship has been found between neuroendocrine functions and symptom domains of psychiatric disorders such as eating disorders and mood disorders. Certain hormones, neurotransmitters and other molecules which might have effect on the basis of eating disorders can be listed as estrogen, serotonin, leptin, ghreline, alpha-melanocyte stimulating hormone, cholecystokinin, dopamine, noradrenaline, brain-derived neurotropic factor, agouti-related protein, neuropeptide-Y, opioids and their receptors, thiamine, zinc, omega-3 acids. In this review, main neuroendocrine-molecular changes and interactions that occur in the eating disorders have been discussed. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2014; 6(4.000: 389-400
Francisco, Rita; Narciso, Isabel; Alarcão, Madalena
This study compared potential risk and protective factors, levels of disordered eating (DE), and their relationship among young aesthetic athletes (elite and non-elite) and controls (N = 725; 62.5 % females; mean age = 15.3, SD = 2.1). The participants completed self-report measures (McKnight Risk Factor Survey-IV, Contour Drawing Rating Scale and Eating Disorder Examination-Questionnaire). Female elite athletes showed a greater risk of developing eating disorders than non-elite athletes and ...
Arthur-Cameselle, Jessyca; Sossin, Kayla; Quatromoni, Paula
Female athletes are at risk for clinical eating disorders, yet their onset experiences have rarely been studied with qualitative methods. This study, which included interviews with 12 collegiate female athletes and 17 non-athletes, identified factors that contributed to eating disorder onset for both subgroups. Inductive content analysis revealed that low self-worth, peer issues, and comorbid psychological disorders were common in both groups. However, athletes reported sport-specific factors including performance pressure, team weigh-ins, and injuries, whereas family dysfunction, bullying, and puberty were more commonly reported triggers for non-athletes. Findings support prevention and treatment programs customized for unique vulnerabilities for each subgroup.
Sharan, Pratap; Sundar, A Shyam
Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations.
Full Text Available Ignacio Jáuregui-LoberaBehavioral Sciences Institute and Pablo de Olavide University, Seville, SpainAbstract: Neuroimaging techniques have been useful tools for accurate investigation of brain structure and function in eating disorders. Computed tomography, magnetic resonance imaging, positron emission tomography, single photon emission computed tomography, magnetic resonance spectroscopy, and voxel-based morphometry have been the most relevant technologies in this regard. The purpose of this review is to update the existing data on neuroimaging in eating disorders. The main brain changes seem to be reversible to some extent after adequate weight restoration. Brain changes in bulimia nervosa seem to be less pronounced than in anorexia nervosa and are mainly due to chronic dietary restrictions. Different subtypes of eating disorders might be correlated with specific brain functional changes. Moreover, anorectic patients who binge/purge may have different functional brain changes compared with those who do not binge/purge. Functional changes in the brain might have prognostic value, and different changes with respect to the binding potential of 5-HT1A, 5-HT2A, and D2/D3 receptors may be persistent after recovering from an eating disorder.Keywords: neuroimaging, brain changes, brain receptors, anorexia nervosa, bulimia nervosa, eating disorders
Sharan, Pratap; Sundar, A. Shyam
Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations. PMID:26330646
Gonzalez, Aranzazu; Kohn, Michael R; Clarke, Simon D
The overall prevalence of eating disorders among children and adolescents is rising - the younger age group are more likely to present with anorexia nervosa (AN), while the older adolescent can present with either AN or bulimia nervosa (BN). However, eating disorders exist as part of a spectrum and general practitioners will encounter many adolescents that have an eating disorder that do not yet fulfil diagnostic criteria for either AN or BN. This article aims to provide an overview of assessment and principles of management of eating disorders in the adolescent patient. General practitioners are key in recognising and offering early intervention in cases of incipient eating disorders or problem dieting behaviour. The physical findings of AN are those of protein calorie malnutrition, while in BN, they reflect chronic purging. Failure of outpatient management requires hospitalisation for nutritional rehabilitation with close monitoring of fluid and electrolyte status to prevent the development of refeeding syndrome. Family involvement is vital, particularly in the younger patient, with ongoing family therapy offering the best outcomes.
Samnaliev, Mihail; Noh, H. LeAnn; Sonneville, Kendrin R.; Austin, S. Bryn
Background: Very little is known about the economic burden of eating disorders (ED) and related mental health comorbidities. Methods: Using 5 years of data from the U.S. Medical Expenditures Panel Survey, we estimated the difference in annual health care costs, employment status, and earned income (2011 US$) between individuals with current ED compared to those without ED. We further estimated the contribution of mental health comorbidities to these disparities in health care costs, employ...
Hay, Phillipa; Mitchison, Deborah; Collado, Abraham Ernesto Lopez; Gonz?lez-Chica, David Alejandro; Stocks, Nigel; Touyz, Stephen
Background Little is known about the epidemiology and health related quality of life (HRQoL) of the new DSM-5 diagnoses, Binge Eating Disorder (BED) and Avoidant/Restrictive Food Intake Disorder (ARFID) in the Australian population. We aimed to investigate the prevalance and burden of these disorders. Methods We conducted two sequential population-based surveys including individuals aged over 15?years who were interviewed in 2014 (n?=?2732) and 2015 (n =3005). Demographic information and diag...
Anastasiadou, Dimitra; Sepulveda, Ana R; Sánchez, Julio César; Parks, Melissa; Álvarez, Tamara; Graell, Montserrat
The aim of this study was to compare the family functioning of Spanish parents of patients with an eating disorder (ED) with that of carers of patients with substance-related disorders (SRDs) and families of healthy controls (HC). This cross-sectional study included 48 mothers and 45 fathers of 48 adolescent patients with an ED, 47 mothers and 37 fathers of 47 patients with an SRD and 66 mothers and 50 fathers of 68 HCs. Families of ED patients reported lower levels of criticism, symptom accommodation and negative caregiving experience than families of SRD patients. However, relatives of both ED and SRD patients reported similar levels of quality of life related to their mental health. Furthermore, families of HCs generally exhibited better scores on all scales assessing their caregiving experiences. Regarding gender differences, there was a tendency in mothers, primarily those from the ED group, to report more adverse experiences as caregivers compared with fathers. Symptoms characteristic to each disorder may be associated with differential patterns of family functioning and may require specifically tailored family interventions. Early family intervention in adolescence is crucial, as relatives' quality of life does not seem to have been badly affected at this point in the course of the illness. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
Goyal, Shrigopal; Balhara, Yatan Pal Singh; Khandelwal, S K
Two of the most commonly used nosological systems- International Statistical Classification of Diseases and Related Health Problems (ICD)-10 and Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV are under revision. This process has generated a lot of interesting debates with regards to future of the current diagnostic categories. In fact, the status of categorical approach in the upcoming versions of ICD and DSM is also being debated. The current article focuses on the debate with regards to the eating disorders. The existing classification of eating disorders has been criticized for its limitations. A host of new diagnostic categories have been recommended for inclusion in the upcoming revisions. Also the structure of the existing categories has also been put under scrutiny.
Mitchison, Deborah; Hay, Phillipa; Griffiths, Scott; Murray, Stuart B; Bentley, Caroline; Gratwick-Sarll, Kassandra; Harrison, Carmel; Mond, Jonathan
The distinctiveness and relative clinical significance of overvaluation, dissatisfaction, and preoccupation with body weight/shape remains inconclusive. This study sought to add to the evidence by testing associations between these three body image constructs and indicators of clinical significance. Male and female secondary students (N = 1,666) aged 12-18 years completed a survey that included measures of dissatisfaction with, overvaluation of, and preoccupation with weight/shape, psychological distress, eating disorder behaviors, and basic demographic information. Conditional process analysis was employed to test the independent and mediating effects of overvaluation, dissatisfaction, and preoccupation on distress, dietary restraint, and objective binge eating. Overvaluation, dissatisfaction, and preoccupation were highly correlated (r = 0.47-0.84). In girls, preoccupation demonstrated the strongest independent and mediating effects on distress, dietary restraint, and binge eating; whereas neither the direct or indirect effects of dissatisfaction on distress and overvaluation on binge eating were significant. Among boys however, the direct and indirect effects of overvaluation, dissatisfaction, and preoccupation on distress and eating disorder behaviors were relatively equal. Preoccupation with weight/shape may be particularly clinically significant in girls, whereas all constructs of body image disturbance may be equally clinically significant in boys. The findings are consistent with the view that these constructs, while closely related, are distinct. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:118-126). © 2016 Wiley Periodicals, Inc.
Kaye, Walter H; Wagner, Angela; Fudge, Julie L; Paulus, Martin
This chapter reviews brain imaging findings in anorexia and bulimia nervosa which characterize brain circuitry that may contribute to the pathophysiology of eating disorders (EDs). Recent imaging studies provide evidence of disturbed gustatory processing in EDs which involve the anterior insula as well as striatal regions. These results raise the possibility that individuals with anorexia nervosa have altered appetitive mechanism that may involve sensory, interoceptive, or reward processes. Furthermore, evidence of altered reward mechanisms is supported by studies that suggest that individuals with anorexia nervosa and bulimia nervosa share a trait toward similar anterior ventral striatal pathway dysregulation. This shared trait disturbance of the modulation of reward and emotionality may create a vulnerability for dysregulated appetitive behaviors. However, those with anorexia nervosa may be able to inhibit appetite and have extraordinary self-control because of exaggerated dorsal cognitive circuit function, whereas individuals with bulimia nervosa are vulnerable to overeating when they get hungry, because they have less ability to control their impulses. Current therapeutic interventions have modest success. Better understanding of neurocircuits that may be related to altered appetite, mood, impulse control, and other symptoms underlying the pathophysiology of EDs might improve psychotherapeutic and drug treatment strategies.
Clark-Stone, Sam; Joyce, Heidi
Eating disorders can be severe and enduring mental illnesses that have serious physical, psychological and social consequences. They can also have a significant effect on the person's friends and family. In this patient group, control of body shape, weight or eating is over-valued and becomes the main or only way of judging self-worth. Eating disorders can be mild and self-limiting, but they commonly run a chronic course unless treatment is successful. Nurses play an important role in early detection, assessment and treatment.
The quality of the prevention of eating disorders represents in several last decades frequently discussed issue in the context of rapidly changing socio-economic conditions, a significant increase of influence of the media, new technologies and knowledge of risk factors. Primary prevention aims to reduce the risk of developing eating disorders, but secondary and tertiary prevention play the important role as well. Effective and coordinated prevention is still missing. Our experience of international cooperation of the last 20 years led to the development and evaluation of prevention programs. We are describing their fast development and ongoing programs following the new trends recommended by WHO.
Atalayer, Deniz; Gibson, Charlisa; Konopacka, Alexandra; Geliebter, Allan
There is growing evidence supporting a multifactorial etiology that includes genetic, neurochemical, and physiological components for eating disorders above and beyond the more conventional theories based on psychological and sociocultural factors. Ghrelin is one of the key gut signals associated with appetite, and the only known circulating hormone that triggers a positive energy balance by stimulating food intake. This review summarizes recent findings and several conflicting reports on ghrelin in eating disorders. Understanding these findings and inconsistencies may help in developing new methods to prevent and treat patients with these disorders. PMID:22960103
Smink, Frédérique R. E.; van Hoeken, Daphne; Hoek, Hans W.
Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increas...
Eating disorders are relatively common and serious disorders in adolescents. However, there are few controlled psychosocial intervention studies with this younger population. This review updates a previous Journal of Clinical Child and Adolescent Psychology review published in 2008. The recommendations in this review were developed after searching the literature including PubMed/Medline and employing the relevant medical subject headings. In addition, the bibliographies of book chapters and treatment guideline articles were reviewed; last, colleagues were asked for suggested additional source materials. Psychosocial treatments examined include family therapy, individual therapy, cognitive behavioral therapy, interpersonal psychotherapy, cognitive training, and dialectical behavior therapy. Using the most recent Journal of Clinical Child and Adolescent Psychology methodological review criteria, family treatment-behavior (FT-B) is the only well-established treatment for adolescents with anorexia nervosa. Family treatment-systemic and insight oriented individual psychotherapy are probably efficacious treatments for adolescents with anorexia nervosa. There are no well-established treatments for adolescents with bulimia nervosa, binge eating disorder, or avoidant restrictive food intake disorder. Possibly efficacious psychosocial treatments for adolescent bulimia nervosa include FT-B and supportive individual therapy. Internet-delivered cognitive behavioral therapy is a possibly efficacious treatment for binge eating disorder. Experimental treatments for adolescent eating disorders include enhanced cognitive behavioral therapy, dialectical behavioral therapy, cognitive training, and interpersonal psychotherapy. FT-B is the only well-established treatment for adolescent eating disorders. Additional research examining treatment for eating disorders in youth is warranted.
Maguen, Shira; Cohen, Beth; Cohen, Greg; Madden, Erin; Bertenthal, Daniel; Seal, Karen
Individuals with mental health problems are at elevated risk for eating disorders. Veterans serving in support of the conflicts in Afghanistan and Iraq (OEF/OIF) have a high prevalence of deployment-related mental health problems, but little is known about their risk for eating disorders. Our aim was to determine rates of eating disorder diagnoses among OEF/OIF veterans with mental health problems, particularly among those with comorbid mental health problems. This retrospective, cross-sectional analysis of nationwide VA healthcare facilities used descriptive statistics and regression analyses to determine eating disorder rates in OEF/OIF veterans who were new users of VA healthcare from October 7, 2001 to December 31, 2010 (N = 593,739). Although the prevalence of eating disorder diagnoses was 0.007% (n = 465) in women and problems were significantly more likely to have an eating disorder than those without mental health diagnoses. Eating disorders were significantly more common in women with depression, posttraumatic stress disorder, and alcohol and/or drug use disorders than in women veterans without these mental health disorders. Among men, the associations between eating disorder diagnoses and comorbid mental health diagnoses closely paralleled those observed in women. Rates of eating disorders are significantly higher among returning veterans with comorbid mental health problems compared with those without mental health diagnoses. Further research should examine methods to improve detection and treatment of eating disorders in this population. Published by Elsevier Inc.
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Maxwell, Hilary; Tasca, Giorgio A; Ritchie, Kerri; Balfour, Louise; Bissada, Hany
An interpersonal model of Binge Eating Disorder (BED) posits that difficulties with social functioning precipitate negative affect, which in turn causes binge eating as a means of coping. Thus, long-term decreases in attachment insecurity may be important for women with BED. No research has assessed if long-term change in attachment insecurity is associated with sustained change in other outcomes. In the current study, we hypothesized that changes in attachment anxiety and avoidance will decrease at posttreatment and will be maintained up to 12 months after Group Psychodynamic Interpersonal Psychotherapy (GPIP). We further hypothesized that long-term stability of these changes in attachment insecurity will be related to other long-term outcomes. Women with BED (N = 102) attended 16 sessions of GPIP. Measures were completed pretreatment, posttreatment, at 6 and 12 months follow-up. Attachment anxiety, attachment avoidance, and the other outcome variables decreased significantly at 12 months posttreatment. Reductions in attachment anxiety and avoidance were significantly related to decreases in interpersonal problems up to 12 months posttreatment, and reduction in attachment anxiety was significantly related to decreases in depressive symptoms 12 months posttreatment. Further, the significant relationship between reduced attachment avoidance and decreased interpersonal problems strengthened over the long term. This is the first study to show an association between change in attachment insecurity and change in other outcomes in the long term, and to show an adaptive spiral in which greater reduction in attachment avoidance is increasingly associated with ongoing improvement of interpersonal problems. (c) 2014 APA, all rights reserved.
Smink, Frédérique R E; van Hoeken, Daphne; Hoek, Hans W
Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms relating to eating disorders and epidemiology. Anorexia nervosa is relatively common among young women. While the overall incidence rate remained stable over the past decades, there has been an increase in the high risk-group of 15-19 year old girls. It is unclear whether this reflects earlier detection of anorexia nervosa cases or an earlier age at onset. The occurrence of bulimia nervosa might have decreased since the early nineties of the last century. All eating disorders have an elevated mortality risk; anorexia nervosa the most striking. Compared with the other eating disorders, binge eating disorder is more common among males and older individuals.
Full Text Available Suicide associated mortality rates are notable for eating disorders. Crude mortality rate associated with suicide, varies between 0% and 5.3% in patients with eating disorders. Prominent risk factors for suicidal behavior among these patients are subtype of the eating disorders, comorbid psychiatric diagnosis (e.g. depression, alcohol and substance abuse, personality disorders, ultrarapid drug metabolism, history of childhood abuse and particular family dynamics. In this article, suicidal behavior and associated factors in eating disorders are briefly reviewed.
Preston, Catherine; Ehrsson, H. Henrik
Historically, body size overestimation has been linked to abnormal levels of body dissatisfaction found in eating disorders. However, recently this relationship has been called into question. Indeed, despite a link between how we perceive and how we feel about our body seeming intuitive, until now lack of an experimental method to manipulate body size has meant that a causal link, even in healthy participants, has remained elusive. Recent developments in body perception research demonstrate that the perceptual experience of the body can be readily manipulated using multisensory illusions. The current study exploits such illusions to modulate perceived body size in an attempt to influence body satisfaction. Participants were presented with stereoscopic video images of slimmer and wider mannequin bodies viewed through head-mounted displays from first person perspective. Illusory ownership was induced by synchronously stroking the seen mannequin body with the unseen real body. Pre and post-illusion affective and perceptual measures captured changes in perceived body size and body satisfaction. Illusory ownership of a slimmer body resulted in participants perceiving their actual body as slimmer and giving higher ratings of body satisfaction demonstrating a direct link between perceptual and affective body representations. Change in body satisfaction following illusory ownership of a wider body, however, was related to degree of (non-clinical) eating disorder psychopathology, which can be linked to fluctuating body representations found in clinical samples. The results suggest that body perception is linked to body satisfaction and may be of importance for eating disorder symptomology. PMID:24465698
Full Text Available Historically, body size overestimation has been linked to abnormal levels of body dissatisfaction found in eating disorders. However, recently this relationship has been called into question. Indeed, despite a link between how we perceive and how we feel about our body seeming intuitive, until now lack of an experimental method to manipulate body size has meant that a causal link, even in healthy participants, has remained elusive. Recent developments in body perception research demonstrate that the perceptual experience of the body can be readily manipulated using multisensory illusions. The current study exploits such illusions to modulate perceived body size in an attempt to influence body satisfaction. Participants were presented with stereoscopic video images of slimmer and wider mannequin bodies viewed through head-mounted displays from first person perspective. Illusory ownership was induced by synchronously stroking the seen mannequin body with the unseen real body. Pre and post-illusion affective and perceptual measures captured changes in perceived body size and body satisfaction. Illusory ownership of a slimmer body resulted in participants perceiving their actual body as slimmer and giving higher ratings of body satisfaction demonstrating a direct link between perceptual and affective body representations. Change in body satisfaction following illusory ownership of a wider body, however, was related to degree of (non-clinical eating disorder psychopathology, which can be linked to fluctuating body representations found in clinical samples. The results suggest that body perception is linked to body satisfaction and may be of importance for eating disorder symptomology.
Masheb, Robin M; Grilo, Carlos M
To examine the relationship of flexible and rigid dimensions of restrained eating to body mass index (BMI) and overeating in outpatients with binge eating disorder (BED). Participants were 148 consecutive outpatients who met criteria for BED. The Three-Factor Eating Questionnaire (TFEQ) was administered to assess Cognitive Restraint, Hunger, and Disinhibition. The TFEQ also contains two Cognitive Restraint subscales--Flexible Control and Rigid Control. The Eating Disorder Examination-Questionnaire version (EDE-Q) was administered to assess frequency of different forms of overeating during the past 28 days and the attitudinal features of eating disorders. Flexible Control and Rigid Control were significantly correlated with each other. They were both negatively correlated with BMI, but neither was significantly correlated with the frequency of binge eating or other forms of overeating. In addition, Flexible Control and Rigid Control predicted almost the same amount of variance in BMI. BED patients exhibit flexible and rigid control of eating that is related to BMI, but not to the frequency of binge eating or other forms of overeating. Results of the present study provide preliminary evidence that flexible and rigid control of eating may not be a useful distinction in BED patients. However, increased restraint, regardless of type, may prove to be of benefit with regard to weight control and may not have adverse effects on binge eating in obese BED patients. Copyright 2002 John Wiley & Sons, Inc.
Pike, Kathleen M.; Hoek, Hans W.; Dunne, Patricia E.
Purpose of review Culture has long been recognized as significant to the cause and expression of eating disorders. We reviewed the recent literature about recent trends in the occurrence of eating disorders in different cultures. Recent findings While historically, eating disorders were
Timofeeva, Elena; Calvez, Juliane
Eating disorders are devastating and life-threatening psychiatric diseases. Although clinical and experimental investigations have significantly progressed in discovering the neuronal causes of eating disorders, the exact neuronal and molecular mechanisms of the development and maintenance of these pathologies are not fully understood. The complexity of the neuronal substrate of eating disorders hampers progress in revealing the precise mechanisms. The present re...
Elran-Barak, Roni; Sztainer, Maya; Goldschmidt, Andrea B; Le Grange, Daniel
Previous studies on family meals and disordered eating have mainly drawn their samples from the general population. The goal of the current study is to determine family meal frequency among children and adolescents with anorexia nervosa (AN), bulimia nervosa (BN), and feeding or eating disorder not elsewhere classified (FED-NEC) and to examine whether family meal frequency is associated with eating disorder psychopathology. Participants included 154 children and adolescents (M = 14.92 ± 2.62), who met criteria for AN (n = 60), BN (n = 32), or FED-NEC (n = 62). All participants completed the Eating Disorder Examination and the Family Meal Questionnaire prior to treatment at the University of Chicago Eating Disorders Program. AN and BN participants significantly differed in terms of family meal frequency. A majority of participants with AN (71.7%), compared with less than half (43.7%) of participants with BN, reported eating dinner with their family frequently (five or more times per week). Family meal frequency during dinner was significantly and negatively correlated with dietary restraints and eating concerns among participants with BN (r = -.381, r = -.366, p meal frequency may be explained by their parents' relatively greater vigilance over eating, whereas families of BN patients may be less aware of eating disorder behaviors and hence less insistent upon family meals. Additionally, children and adolescents with AN may be more inhibited and withdrawn and therefore are perhaps more likely to stay at home and eat together with their families. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Sapia, Jennifer L.
This paper provides information for school psychologists regarding the necessity and benefits of school-based prevention programming for students at risk for developing eating disorders (i.e., females). School-based programming is a cost-effective means of reaching the largest number of individuals at once and identifying those individuals…
Moriarty, Dick; Moriarty, Mary
Since sports can sometimes lend themselves to eating disorders, coaches and sports administrators must get involved in the detection and treatment of this problem. While no reliable studies or statistics exist on the incidence of anorexia nervosa and/or bulimia among athletes, some research suggests that such disorders occur frequently among…
Schousboe, Birgitte Hartvig; Waaddegaard, Mette
Binge eating disorder kaldes også bulimi uden opkastning eller den tredje spiseforstyrrelse. Det er en udbredt, men mindre kendt spiseforstyrrelse end anoreksi og bulimi. Patienterne er ofte overvægtige og har ikke kompenserende adfærd over for overspisningen i form af opkastning eller brug af...
Granner, Michelle L.; Black, David R.; Abood, Doris A.
Examined smoking and drinking levels relative to body dissatisfaction and drive for thinness among female college students. Student surveys indicated that frequency of smoking and drinking significantly and linearly related to body dissatisfaction and drive for thinness. Negative-affect reduction motivations for use of these substances more…
Stice, Eric; Presnell, Katherine; Bearman, Sarah Kate
Used interview data from a community study to test whether early menarche partially accounts for increased depression, eating pathology, substance abuse, and comorbid psychopathology among adolescent girls. Found that menarche prior to 11.6 years related to elevated depression and substance abuse. Findings support assertion that early menarche is…
O. N. Komarova; A. I. Khavkin
Eating disorder is observed in infants at different developmental stages. This condition may be caused by comorbidities, organic diseases, or psychogenic causes. After birth, a child’s eating behavior evolves, which largely depends on the relations arising between him, his mother, and other family members. Eating disorders may be caused by an impaired child-mother relationship: inadequate maternal behavior, excessive or poor parenteral attention. The treatment of eating disorders involves a c...
This thesis concerns addictive substance abuse in women suffering from eating disorders. In the theoretical part it defines the term eating disorder itself and furthermore briefly works with the cause of these disorders, patients' personality and commonly associating complicating diagnoses. Afterwards it defines the term addiction and illustrates some of the possible influences on development. Then it characterises commonly abused substances and their relation with eating disorders. The empir...
Acevedo, Summer F; Valencia, Celeste; Lutter, Michael; McAdams, Carrie J
Oxytocin is a peptide hormone important for social behavior and differences in psychological traits have been associated with variants of the oxytocin receptor gene in healthy people. We examined whether single nucleotide polymorphisms (SNPs) of the oxytocin receptor gene (OXTR) correlated with clinical symptoms in women with anorexia nervosa, bulimia nervosa, and healthy comparison (HC) women. Subjects completed clinical assessments and provided DNA for analysis. Subjects were divided into four groups: HC, subjects currently with anorexia nervosa (AN-C), subjects with a history of anorexia nervosa but in long-term weight recovery (AN-WR), and subjects with bulimia nervosa (BN). Five SNPs of the oxytocin receptor were examined. Minor allele carriers showed greater severity in most of the psychiatric symptoms. Importantly, the combination of having had anorexia and carrying either of the A alleles for two SNPS in the OXTR gene (rs53576, rs2254298) was associated with increased severity specifically for ED symptoms including cognitions and behaviors associated both with eating and appearance. A review of psychosocial data related to the OXTR polymorphisms examined is included in the discussion. OXTR polymorphisms may be a useful intermediate endophenotype to consider in the treatment of patients with anorexia nervosa. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Yanase, Maya; Sugihara, Genichi; Murai, Toshiya; Noma, Shun'ichi
To explore the characteristics of eating disorders related to shoplifting behavior and identify the risk and protective factors related to shoplifting among patients with eating disorders. Eighty females with eating disorders were recruited from an eating disorders clinic. They were asked to complete anonymous self-report questionnaires on demographic characteristics, shoplifting behavior, psychological characteristics and eating disorder symptomology. We investigated differences in clinical characteristics between those with and without shoplifting history or a current drive to shoplift. The response rate was 92.5%. Of the respondents, 37.8% reported a history of shoplifting and 16.2% a current drive for shoplifting. The patients with shoplifting history had lower socioeconomic status (SES), higher impulsivity and higher symptom severity of eating disorders compared with those without this history. The patients with a current drive for shoplifting had more depressive symptoms, more severe anxiety, more obsessional traits, and higher symptom severity of eating disorders. Severity of illness and SES seem to have a serious impact on shoplifting behavior among eating disordered patients. These findings may suggest risk and protective factors related to shoplifting among eating disordered patients.
Sepulveda, Ana R; Kyriacou, Olivia; Treasure, Janet
Abstract Background Families of people with eating disorders are often caught up in rule bound eating and safety behaviours that characterise the illness. The main aim of this study was to develop a valid and specific scale to measure family accommodation in the context of having a relative with an eating disorder. Methods A new scale, the Accommodation and Enabling Scale for Eating Disorders (AESED), was jointly generated by professionals and expert carers through qualitative analysis. In th...
Eddy, Kamryn T; Celio Doyle, Angela; Hoste, Renee Rienecke; Herzog, David B; le Grange, Daniel
To examine the frequency, type, and clinical severity of eating disorder not otherwise specified (EDNOS) in adolescents seeking treatment through an outpatient eating disorders service. Two hundred eighty-one consecutive referrals to an eating disorders program were assessed using the Eating Disorder Examination (EDE) and self-report measures of depression and self-esteem. The majority of adolescents presented with EDNOS (59.1%; n = 166) relative to anorexia nervosa (AN; 20.3%; n = 57) and bulimia nervosa (BN; 20.6%; n = 58). Most EDNOS youths could be described as subthreshold AN (SAN; 27.7%; n = 46), subthreshold BN (SBN; 19.9%; n = 33), EDNOS purging (27.7%; n = 46), or EDNOS bingeing (6.0%; n = 10); yet 31 (18.7%) could not be categorized as such (EDNOS "other"). Overall differences in eating disorder pathology, depressive symptoms, and self-esteem emerged between the EDNOS types, wherein adolescents with EDNOS bulimic variants (SBN, EDNOS purging, and EDNOS bingeing) had more pathology than youths with SAN or EDNOS "other." There were no differences in these variables between AN and SAN; in contrast, compared with BN, youths with EDNOS bulimic variants reported lower EDE scores and higher self-esteem, although there were no between-group differences in depression. As in adults with eating disorders, EDNOS predominates and is heterogeneous with regard to eating disorder pathology and associated features in an adolescent clinical sample. Lack of differences between AN and SAN suggests that the strict criteria for AN could be relaxed; differences between BN and EDNOS bulimic variants do not support their combination.
Saul, Jennifer S; Rodgers, Rachel F
The proliferation of social media and rapid increase in the use of the Internet by adolescents generates new dynamics and new risks for the development and maintenance of eating disorders. Here, the authors review different types of online content and how they are relevant to eating disorders within different theoretic frameworks, before examining the empirical evidence for the risks posed by online content in the development and maintenance of eating disorders. They describe pro-eating disorder content specifically and examine the research related to it, before considering its implications, and considering directions for future research, and prevention and intervention strategies. Copyright © 2017 Elsevier Inc. All rights reserved.
Ringham, Rebecca; Klump, Kelly; Kaye, Walter; Stone, David; Libman, Steven; Stowe, Susan; Marcus, Marsha
The current study sought to compare eating disorder symptomatology among ballet dancers and individuals with restricting anorexia nervosa (RAN), bulimia nervosa (BN), and no eating pathology. Twenty-nine female ballet dancers completed assessments and were compared with an archival dataset of 26 women with RAN, 47 women with BN, and 44 women with no eating pathology. Eating disorder diagnoses and behaviors were assessed with a semi-structured clinical interview, the Eating Disorder Inventory (EDI), and a weight history interview. Eighty-three percent of dancers met lifetime criteria for AN (6.9%), BN (10.3%), AN+BN (10.3%), or EDNOS (55.0%). Moreover, dancers looked more similar to eating-disordered individuals than to control individuals on measures of eating pathology. Despite previous emphasis on the pathology AN, the current findings suggest that dancers frequently engage in binge eating and purging behaviors. Moreover, it appears that their pathology is as severe as that of non-dancing women with eating disorders. Copyright (c) 2006 by Wiley Periodicals, Inc.
Thaler, Lea; Steiger, Howard
Eating disorders (EDs) are characterized by intense preoccupation with shape and weight and maladaptive eating practices. The complex of symptoms that characterize EDs often arise through the activation of latent genetic potentials by environmental exposures, and epigenetic mechanisms are believed to link environmental exposures to gene expression. This chapter provides an overview of genetic factors acting in the etiology of EDs. It then provides a background to the hypothesis that epigenetic mechanisms link stresses such as obstetric complications and childhood abuse as well as effects of malnutrition to eating disorders (EDs). The chapter then summarizes the emerging body of literature on epigenetics and EDs-mainly studies on DNA methylation in samples of anorexia and bulimia. The available evidence base suggests that an epigenetically informed perspective contributes in valuable ways to the understanding of why people develop EDs.
Ignacio Jáuregui-Lobera1,21Behavioral Sciences Institute, 2Pablo de Olavide University, Seville, SpainAbstract: Clinical applications of electroencephalography (EEG) are used with different objectives, EEG being a noninvasive and painless procedure. In respect of eating disorders, in the 1950s a new line of study about the neurological bases of anorexia nervosa was started and has since been developed. The purpose of this review is to update the existing literature data on the main...
Goebel-Fabbri, Ann E.
The problem of insulin restriction is an important women's health issue in type 1 diabetes. This behavior is associated with increased rates of diabetes complications and decreased quality of life. Clinical and technological research is greatly needed to improve treatment tools and strategies for this problem. In this commentary, the author describes the scope of the problem of eating disorders and diabetes, as well as offers ideas about ways technology may be applied to help solve this compl...
?gh, Tam?s; Kov?cs, G?bor; Supina, Dylan; Pawaskar, Manjiri; Herman, Barry K.; Vok?, Zolt?n; Sheehan, David V.
Purpose To perform a systematic review of the health-related quality of life (HRQoL) and economic burdens of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). Methods A systematic literature search of English-language studies was performed in Medline, Embase, PsycINFO, PsycARTICLES, Academic Search Complete, CINAHL Plus, Business Source Premier, and Cochrane Library. Cost data were converted to 2014 Euro. Results Sixty-nine studies were included. Data on HRQoL were...
Katayama, Hiroto; Kohmura, Kunihiro; Tanaka, Satoshi; Imaeda, Miho; Kawano, Naoko; Noda, Yukihiro; Nishioka, Kazuo; Ando, Masahiko; Aleksic, Branko; Iidaka, Tetsuya; Ozaki, Norio
Functional neuroimaging techniques are widely used to elucidate changes in brain activity, and various questionnaires are used to investigate psychopathological features in patients with eating disorders (ED). It is well known that social skills and interpersonal difficulties are strongly associated with the psychopathology of patients with ED. However, few studies have examined the association between brain activity and social relationships in patients with ED, particularly in patients with extremely low body weight. In this study, 22-channel near-infrared spectroscopy was used to quantify regional hemodynamic changes during a letter fluency task (LFT) in 20 female patients with ED with a mean body mass index of 14.0 kg/m(2) and 31 female controls (CTLs). Symptoms were assessed using the Eating Disorder Inventory-2 and Beck Depression Inventory. We hypothesized that frontal activity in patients with ED would be lower than in CTLs and would show different correlations with psychopathological features compared with CTLs. The LFT performance and score on the social insecurity subscale of the Eating Disorder Inventory-2 were significantly higher in the ED group than in the CTL group. The mean change in oxygenated hemoglobin (oxy-Hb) in bilateral frontal regions during the LFT was significantly smaller in the ED group than in the CTL group. Social insecurity score was positively correlated with the concentration of oxy-Hb in the bilateral orbitofrontal cortex in the ED group but not in the CTL group. These results suggest that activity of the orbitofrontal cortex is associated with social insecurity and disturbed in patients with ED. Therefore, disturbed orbitofrontal cortex activity may underlie the lack of insight and social isolation that is characteristic of patients with ED.
Herpertz, S; Petrak, F; Kruse, J; Kulzer, B; Lange, K; Albus, C
Adolescent and young women with type 1 diabetes mellitus demonstrate a more than random coincidence with bulimia nervosa. However, the prevalence of eating disorders that do not fulfil the criteria of bulimia nervosa is also raised in women of this age group yet without diabetes mellitus. The comorbidity of type 1 diabetes and an eating disorder poses a risk factor in the development of diabetic follow-up diseases. Patients with an eating disorder and type 1 diabetes are characterized by an insufficient metabolic control and the early development of diabetic complications such as a retinopathy. The binge eating disorder, according to research aspects initially a new eating disorder entity, may especially be observed in overweight and obesity. Even if a binge eating disorder in persons with a type 2 diabetes does not occur more frequently than in those metabolically healthy persons, it does depict a risk factor for an accelerated weight gain which as rule involves an increase of insulin resistance.
Chang, Yu-Jhen; Lin, Wei; Wong, Yueching
Eating disorders are now a global health problem for adolescents and young female adults. The level of eating disorders among young female adults is growing in Asian countries. Therefore, the purpose of this study was to investigate body image, weight concerns, eating attitudes, dietary intake, and nutritional status related to eating disorders of female high school students in Taiwan. A total of 1605 female high school students participated in this study. The written questionnaire included respondents' demographics and weight concerns, the Eating Attitudes Test-26 (EAT-26), and 24-hour dietary recall. Blood chemistry data were also collected. The data were analyzed using a Student t test, χ(2) analysis, and logistic regression. Disturbed eating attitudes and behaviors were found in 17.11% of participants (measured by an EAT-26 score ≥20). Logistic regression analyses showed that disturbed eating attitudes/behaviors were significantly associated with overestimation of body weight, unrealistic body weight goal, dissatisfaction with body weight, and weight loss experiences. The reported intakes of energy, protein, carbohydrate, zinc, and vitamins B6 and B12 were significantly lower in participants with disturbed eating patterns than in participants without disturbance issues. Conversely, participants with disturbed eating patterns had higher dietary and crude fiber intake than participants without disturbed eating issues. The percentage of participants with abnormal values of total iron-binding capacity and serum iron was significantly higher in those with disturbed eating patterns than in those without disturbed eating patterns. Disturbed eating attitudes/behaviors exist among female adolescents in Taiwan, and these behaviors jeopardize their nutritional status. The possibility of using the EAT-26 as a reference to predict the quality and quantity of food intake among female adolescents is worthy of further study.
Winkler, Laura Vad; Christiansen, Erik; Lichtenstein, Mia Beck
not otherwise specified (EDNOS) and binge eating disorder (BED) and used the Medical Outcomes Study Short Form-36 Health Survey (SF-36) as a measure of HRQoL. Of the 102 citations identified, 85 abstracts were reviewed and seven studies were included in the meta-analysis. AN patients were included in five......Eating disorders (EDs) comprise a variety of symptoms and have a profound impact on everyday life. They are associated with high morbidity and mortality. The objective of this study was to analyse published data on health-related quality of life (HRQoL) in EDs so as to compare the results...... to general population norm data and to investigate potential differences between ED diagnostic groups. A systematic review of the current literature was conducted using a keyword-based search in PubMed and PsychInfo. The search covered anorexia nervosa (AN), bulimia nervosa (BN), eating disorders...
Binge eating disorder is a common eating disorder that recently has received increasing attention. Goals in treating binge eating disorder typically include controlling binge eating and diminishing excess body weight. A variety of treatment approaches have been used, including diet/lifestyle modification, psychotherapy, and pharmacologic treatment. Diet and lifestyle interventions are somewhat effective in diminishing the binge eating behavior and lead to modest weight loss, but the weight ef...
Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.
Eating disorders are relatively rare among the general population. This review discusses the literature on the incidence, prevalence and mortality rates of eating disorders. We searched online Medline/Pubmed, Embase and PsycINFO databases for articles published in English using several keyterms
Hoek, HW; van Hoeken, D
Objective: To review the literature on the incidence and prevalence of eating disorders. Methods: We searched Medline using several key terms relating to epidemiology and eating disorders and we checked the reference lists of the articles that we found. Special attention has been paid to
Goodale, Kimberly R.; Watkins, Patti Lou; Cardinal, Bradley J.
Examined symptoms of muscle dysmorphia (MD), a variation of the eating disorders anorexia nervosa and bulimia, among college students. Surveys indicated that MD symptomatology appears in the general population and among both sexes. MD significantly related to eating disorder pathology and depression, and to some degree to impaired social support.…
Griffith, Emma; Kuyken, Willem; Watkins, Ed; Jones, Alysun
The cognitive model suggests memory biases for weight/shape and food related information could be important in the maintenance of eating disorders. The current study aims to evaluate this and extend previous research by (a) including females with eating disorder not otherwise specified (EDNOS) as a discreet group; (b) considering whether levels of hunger and the pleasantness of the stimulus words are important in word recall. The study includes three groups of females, 16 with bulimia nervosa, 18 with EDNOS and 17 non-dieting general population controls. All participants completed a self-referential encoding and memory recall task. A main effect of word type (p eating disorder groups recalled significantly more weight/shape and food words compared to all other word categories (p eating disorder groups. In relation to the recall of food words, no significant differences were found between groups for levels of hunger. Both eating disorder groups rated the negative weight/shape (p < .01), negative food (p < .01) and neutral body words (p < .01) as more unpleasant than the control group. The implications for cognitive theory and future research are discussed.
Pike, Kathleen M; Hoek, Hans W; Dunne, Patricia E
Culture has long been recognized as significant to the cause and expression of eating disorders. We reviewed the recent literature about recent trends in the occurrence of eating disorders in different cultures. While historically, eating disorders were conceptualized as primarily afflicting Caucasian adolescent or young adult women within high-income, industrialized Western Europe and North America, eating disorders are increasingly documented in diverse countries and cultures worldwide. This study highlights recent trends that reflect the changing landscape of culture and eating disorders: stabilization of the incidence of anorexia nervosa and possibly lower incidence rates of bulimia nervosa in Caucasian North American and Northern European groups; increasing rates of eating disorders in Asia; increasing rates of eating disorders in the Arab region; and increasing rates of binge eating and bulimia nervosa in Hispanic and Black American minority groups in North America. The changing face of eating disorders calls for a new conceptualization of culture in both the emergence and spread of eating disorders across the globe.
Francisco, Rita; Narciso, Isabel; Alarcão, Madalena
This study compared potential risk and protective factors, levels of disordered eating (DE), and their relationship among young aesthetic athletes (elite and non-elite) and controls (N = 725; 62.5 % females; mean age = 15.3, SD = 2.1). The participants completed self-report measures (McKnight Risk Factor Survey-IV, Contour Drawing Rating Scale and Eating Disorder Examination-Questionnaire). Female elite athletes showed a greater risk of developing eating disorders than non-elite athletes and controls, with no difference between the three groups of males. Multiple group analyses revealed important differences in DE predictors. Although social pressure is the strongest DE predictor in non-elite athletes and controls, in elite athletes, the strongest DE predictor is body image dissatisfaction. Parental influences, rather than self-esteem, are predictors of DE in elite athletes, unlike the other two groups. These results show that the risk and protective factors involved in the development of DE are not universally valid. The results highlight the importance of studying specific characteristics associated with DE in aesthetic athletes. Some implications for ED risk assessment and prevention are discussed.
Roncero, María; Belloch, Amparo; Perpiñá, Conxa; Treasure, Janet
The main objective of the present study was to analyse the role of the ego-dystonicity and ego-syntonicity of eating disorder intrusive thoughts (EDITs) in the genesis and maintenance of eating disorders (EDs). Participants were 98 female patients with EDs, 56 Spanish and 42 English (27.19±9.59 years; body mass index (BMI): 18.72±2.87). All of them completed the eating attitudes test, the Eating Attitudes Test, the Eating Intrusive Thoughts Inventory, the Ego-Dystonicity Questionnaire-Reduced version, and the Ego-Syntonicity Questionnaire. Patients indicated that their EDITs were rational and also undesirable and immoral, suggesting that EDITs are not fully ego-syntonic or ego-dystonic. Multivariate analysis of variance (MANOVA) indicated no differences in ego-syntonicity and ego-dystonicity across ED subtypes. Path analyses were performed to investigate the mediating role of the EDITs' ego-syntonicity and ego-dystonicity in their interference, dysfunctional appraisals and control strategies. They showed, first, that the more interference an EDIT caused, the more ego-syntonic and the less ego-dystonic it was and, second, that when the EDITs were assessed as ego-syntonic, patients tried to do what they indicated, whereas when they were assessed as ego-dystonic, patients made efforts to neutralise them. Clinical implications for the conceptualisation and treatment of ED are discussed. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Eating disorders should be understood in a multidimensional perspective, emphasizing a biopsicossocial context. In these pathologies it`s the body, in the first instance, that reveals the disease, being in this way the target of the conflict, revealing a disturbed body experience and as a consequence a weak conception of their personal body image. The body image is conceptualised as a subjective image that the individuals form in their own mind, about their body, in relation with differ- ent contexts of life. The intent of the studies is to comprehend the level of body image disturbance, which have concluded that in the majority of the cases, significant changes on perceptive capacity of the patients do not exist. In this way it`s important to study in a more effective and qualitative way the affective and personal factors. The authors pretend with this bibliographic revision, make a research of body image assessment to the Eating Disorders (Anorexia Nervosa and Bulimia Nervosa, and to reflect which are the best ones to adapt for Portuguese reality.
Ferrer-Garcia, Marta; Pla-Sanjuanelo, Joana; Dakanalis, Antonios; Vilalta-Abella, Ferran; Riva, Giuseppe; Fernandez-Aranda, Fernando; Sánchez, Isabel; Ribas-Sabaté, Joan; Andreu-Gracia, Alexis; Escandón-Nagel, Neli; Gomez-Tricio, Osane; Tena, Virginia; Gutiérrez-Maldonado, José
Eating behavior style (emotional, restrictive, or external) has been proposed as an explanation for the differences in response to food-related cues between people who overeat and those who do not, and has been also considered a target for the treatment of eating disorders (EDs) characterized by lack of control over eating and weight-related (overweight/obesity) conditions. The aim of this study was to analyze the relationship between eating behavior style and psychophysiological responses (self-reported food craving and anxiety) to food-related virtual reality (VR) environments in outpatients with bulimia nervosa (BN) and binge eating disorder (BED) and to compare them with healthy participants. Fifty-eight outpatients and 135 healthy participants were exposed to palatable foods in four experimental everyday real-life VR environments (kitchen, dining room, bedroom and café). During exposure, cue-elicited food craving and anxiety were assessed. Participants also completed standardized instruments for the study purposes. ED patients reported significantly higher levels of craving and anxiety when exposed to the virtual food than healthy controls. Eating behavior styles showed strong associations with cue-elicited food craving and anxiety. In the healthy group, external eating was the only predictor of cue-elicited craving and anxiety. In participants with BN and BED, external and emotional eating were the best predictors of cue-elicited craving and anxiety, respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.
Behar A, Rosa; Manzo G, Rodrigo; Casanova Z, Dunny
Low self-assertion has been noted as an important feature among patients with eating disorders. To verify, in a female population, if assertiveness is related or has a predictive capacity for the development of eating disorders. An structured clinical interview, the Eating Attitudes Test (EAT-40) and the Rathus Assertiveness Scale (RAS) were administered to 62 patients that fulfilled the DSM-IV diagnostic criteria for eating disorders and to 120 female students without eating problems. Patients with eating disorders ranked significantly higher on the EAT-40 and its factors (p <0.001) and showed a lower level of assertiveness on the RAS (p <0.001). Assertiveness measured by RAS and its factors was inversely related to EAT-40 and its items (r= -0.21). The predictive capability of the lack of self-assertion in the development of an eating disorder reached 53%, when patients with eating disorders and subjects at risk were considered together and compared to students without such disorder. Lack of assertiveness is a significant trait in patients with eating disorders; it may worsen its outcome and even perpetuate symptoms. Low self-assertion may be considered a predictive factor in the development of an eating disorder and must be managed from a preventive or therapeutic point of view.
Grenon, Renee; Tasca, Giorgio A; Cwinn, Eli; Coyle, Doug; Sumner, Amanda; Gick, Mary; Bissada, Hany
Depression is a most burdensome illness, with personal and societal costs surpassing those of any other illness. Furthermore, depression affects women at a much higher rate than men. The most prevalent eating disorder among adult women is binge eating disorder (BED). Depression and obesity are common in women with BED, most of whom seek treatment later in life. Depression, obesity, and age are associated with greater health care use and lower health-related quality of life (HRQOL). Hence, for women with BED estimating the effects of depression can be confounded by both age and body mass index (BMI). The current study examined the relationships between depression, HRQOL, and health care utilization among treatment seeking women with BED. Participants (n = 105) completed the Structured Clinical Interview for DSM-IV, a health care utilization and cost survey, the Personality Assessment Inventory depression scale, and the EQ-5D to measure HRQOL. On average, participants were severely obese with a mean BMI of 38.20 (SD = 6.80); 67.27% had a lifetime history of depression. Participants had higher health care costs and lower HRQOL than published age- and gender-matched norms. After controlling for age and BMI, depressive symptoms were significantly related to greater medication use (excluding antidepressants), and lower HRQOL. Results suggest that targeting depressive symptoms may reduce the economic and personal burden of BED for women. Copyright © 2010 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Pilecki, Maciej W; Józefik, Barbara; Salapa, Kinga
To assess the correlations between the perception of relations in parents' families of origin and the assessment of the current family by the parents and their daughters suffering from eating disorders. STUDIED GROUP: Statistical analyses were applied to the results obtained from 54 patients diagnosed with restrictive anorexia nervosa, from 22 with binge-purge anorexia, from 36 with bulimia and from two control groups: 36 patients diagnosed with depressive disorders and 85 Krakow schoolgirls. The study also covered the parents of the investigated girls. Family of Origin Scale and Family Assessment Questionnaire (FAM Polish version) were used in the study. The procreative family assessment made by the mothers was correlated with the assessment of their own generational family and the assessment of own generational family made by their husbands. Procreative family assessment made by the fathers was correlated only with their assessment of their family of origin. Family of origin assessment made by patients with diagnosed eating disorders, particularly bulimia, was correlated only with the family of origin assessment made by their fathers. The last correlation did not occur in the control groups. The research shows a correlation between the experience of the families of origin and the current functioning of the family. They show the impact of the fathers' trangenerational experience on the perception of family relations of daughters with diagnosed anorexia and bulimia nervosa.
Eddy, Kamryn T.; Doyle, Angela Celio; Hoste, Renee Rienecke; Herzog, David B.; Le Grange, Daniel
A study to examine the kind of eating disorders not otherwise specified (EDNOS) among adolescents encountered during treatment at an outpatient eating disorder clinic is conducted. Results indicate that EDNOS is more predominant among adolescents seeking treatment for eating disorders.
French historian and literary critic René Girard (1923-2015), most widely known for the concepts of mimetic desire and scapegoating, also engaged in the discussion of the surge of eating disorders in his 1996 essay Eating Disorders and Mimetic Desire. This article explores Girard's ideas on the mimetic nature and origin of eating disorders from a clinical psychiatric perspective and contextualizes them within the field of eating disorders research as well as in relation to broader psychological, sociological and anthropological models of social comparison and non-consumption. Three main themes in Girard's thinking on the topic of eating disorders are identified and explored: the 'end of prohibitions' as a driving force in the emergence of eating disorders, eating disorders as a phenomenon specific to modernity, and the significance of 'conspicuous non-consumption' in the emergence of eating disorders.
Fairburn, Christopher G.; Cooper, Zafra; Bohn, Kristin; O?Connor, Marianne E.; Doll, Helen A.; Palmer, Robert L.
?Eating disorder NOS? is the most common eating disorder encountered in outpatient settings yet it has been neglected. The aim of this study was to describe the characteristics of eating disorder NOS, establish its severity, and determine whether its high relative prevalence might be due to the inclusion of cases closely resembling anorexia nervosa or bulimia nervosa. One hundred and seventy consecutive patients with an eating disorder were assessed using standardised instruments. Operational...
The present article discusses eating disorders. Eating disorders are defined as a serious health threat due to an abnormal relation to food which has become a way of coping with stress. They are also often linked to personality disorders. We have focused mainly on the three most common types of eating disorder – anorexia, bulimia, and compulsive (binge) eating – their recognizable features, the causes that lead to eating disorders, and on preventive measures practiced in ...
Saucedo-Molina, Teresita de Jesús; Escamilla-Talón, Teresa Adriana; Portillo-Noriega, Ingrid Edith; Peña-Irecta, Amanda; Calderón-Ramos, Zuli
To determine the distribution and relation of risk factors: biological (body mass index (BMI), sexual maturity) psychological (eating behaviours, body unsatisfied), and sociocultural (publicity influence and distress with body shape) factors associated to eating disorders in Mexican pubescent from Hidalgo, Mexico. A field transversal descriptive and correlational design was carried away with a probabilistic sample of 2194 pubescent (males 48%; females 52%), between 11 and 15 years (X = 13.2; DE = 1.03) junior high students. A self-report questionnaire on eating behaviours, body image, sociocultural factors and sexual maturity was applied. BMI was obtained from each subject. The date showed that the majority (57% of females and 61.6% of males) was unsatisfied with their body shape as well as important percentages of distress of body shape (28% females; 14% males). Both females (25%) and males (16%) eliminate food times. About restrictive dieting the percentage between males (6%) and females (5.2%) were very similar. Only females showed preoccupation about weight and food (17.2%). As a BMI increased, unsatisfied with body shape (r = 0.552, p < 0.01) increased too. As well increased influence of publicity, distress of body shape increased too (r = 0.586, p < 0.01). These facts are deemed relevant to the etiophatology, prevention and treatment of eating disorders in Mexican pubescent.
Full Text Available Few studies have used diffusion tensor imaging (DTI to investigate the micro-structural alterations of WM in patients with restrictive eating disorders (rED, and longitudinal data are lacking. Twelve patients with rED were scanned at diagnosis and after one year of family-based treatment, and compared to twenty-four healthy controls (HCs through DTI analysis. A tract-based spatial statistics procedure was used to investigate diffusivity parameters: fractional anisotropy (FA and mean, radial and axial diffusivities (MD, RD and AD, respectively. Reduced FA and increased RD were found in patients at baseline in the corpus callosum, corona radiata and posterior thalamic radiation compared with controls. However, no differences were found between follow-up patients and controls, suggesting a partial normalization of the diffusivity parameters. In patients, trends for a negative correlation were found between the baseline FA of the right anterior corona radiata and the Eating Disorder Examination Questionnaire total score, while a positive trend was found between the baseline FA in the splenium of corpus callosum and the weight loss occurred between maximal documented weight and time of admission. A positive trend for correlation was also found between baseline FA in the right anterior corona radiata and the decrease in the Obsessive-Compulsive Inventory Revised total score over time. Our results suggest that the integrity of the limbic-thalamo-cortical projections and the reward-related circuitry are important for cognitive control processes and reward responsiveness in regulating eating behavior.
Full Text Available Large variability in tests and differences in scoring systems used to study central coherence in eating disorders may lead to different interpretations, inconsistent findings and between study discrepancies. This study aimed to address inconsistencies by collating data from several studies from the same research group that used the Rey Osterrieth Complex Figure Test (Rey Figure in order to produce norms to provide benchmark data for future studies.Data was collated from 984 participants in total. Anorexia Nervosa, Bulimia Nervosa, recovered Anorexia Nervosa, unaffected family members and healthy controls were compared using the Rey Figure.Poor global processing was observed across all current eating disorder sub-groups and in unaffected relatives. There was no difference in performance between recovered AN and HC groups.This is the largest dataset reported in the literature and supports previous studies implicating poor global processing across eating disorders using the Rey Figure. It provides robust normative data useful for future studies.
Yamaguchi, N; Kobayashi, J; Tachikawa, H; Sato, S; Hori, M; Suzuki, T; Shiraishi, H
We examined parental, personality, and symptomatological characteristics in relation to suicide attempts among eating disorder patients. Fifty-one eating disorder inpatients, divided into two groups according to lifetime suicide attempts, and 107 non-psychiatric subjects were compared on the following variables: Parental Bonding Instrument (PBI), Global Clinical Score (GCS), Eating Disorder Inventory-91 (EDI-91), Eating Attitudes Test-26 (EAT), clinical and personality characteristics, and family backgrounds. Suicidal patients reported significantly higher overprotection by both parents than non-suicidal patients and non-psychiatric subjects. Suicidal patients had a more prevalent history of child abuse, affective instability, unstable self-image, avoidance of abandonment, maladaptive perfectionism, personality disorder, and mood disorder. There were no differences in symptomatological factors or the severity of the eating disorders. The results suggest that high overprotection is associated with suicidal behaviour in eating disorder patients. The association between overprotective parenting and personality characteristics, and methods of suicide prevention are discussed briefly.
Mitchell, James E; Redlin, Jennifer; Wonderlich, Steve; Crosby, Ross; Faber, Ron; Miltenberger, Ray; Smyth, Joshua; Stickney, Marci; Gosnell, Blake; Burgard, Melissa; Lancaster, Kathy
Compulsive buying has received increased research attention in the last decade. The disorder has high rates of comorbidity for other disorders, including eating disorders. This study explored the possible relationship between compulsive buying and eating disorders. Twenty women who scored in the pathological range on a measure of compulsive buying and 20 controls were recruited via the media. Various measures of psychopathology and eating disorder symptoms were administered to both groups. Compulsive buyers were significantly more likely to have a higher lifetime history of substance abuse or dependence. No differences existed between normal controls and compulsive buyers in prevalence of current or lifetime eating disorders, nor were there differences in scores of eating-related psychopathology. This work failed to demonstrate an increased risk for eating disorder in compulsive buyers, although a higher rate of substance dependence or abuse and higher scores on pathological personality dimension scales were seen.
Cummins, Lillian Huang; Simmons, Angela M; Zane, Nolan W S
There is increasing evidence that eating disorders are present among ethnically diverse populations, and researchers have suggested that investigations in this area may inform the field's understanding of how sociocultural factors are related to the development of eating disorders. Although it is generally accepted that sociocultural factors are key in eating disorder etiology, knowledge on how best to study these influences in diverse groups is still limited. In this article, the authors review how the research literature has explored relationships among culture, ethnicity, and eating disorders in Asian populations and critically examine strategies that have been used to investigate these issues across 1 ethnic/racial group. The methodological challenges encountered in these approaches are identified and considered in the provision of recommendations for future endeavors to improve the field's understanding of how culture is related to eating disorders.
Vo, Megen; Accurso, Erin C; Goldschmidt, Andrea B; Le Grange, Daniel
Eating disorder diagnostic criteria were revised from the fourth to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and -5, respectively). This study examines the impact of these revisions on rates of eating disorder diagnoses in treatment-seeking youth. Participants were 651 youth, ages 7-18 years, presenting to an outpatient eating disorders program who met criteria for a DSM-IV eating disorder diagnosis on intake. Patients completed well-validated semi-structured interviews to assess eating disorder psychopathology and psychiatric comorbidity. Participants were predominantly female (n = 588; 90.3%) with an average age of 15.28 years (SD = 2.21), mean percent of median Body Mass Index (mBMI) of 101.91 (SD = 31.73), and average duration of illness of 16.74 months (SD = 17.63). Cases of DSM-IV Eating Disorder Not Otherwise Specified (EDNOS), now most consistent with DSM-5 Other Specified Feeding or Eating Disorder, decreased from 47.6% to 39.0%, Anorexia Nervosa increased from 29.6% to 33.5%, and Bulimia Nervosa increased from 22.7% to 24.7%. Consistent with previous studies, and in keeping with the aims of the DSM-5 for eating disorders, the revised diagnostic criteria reduced cases of DSM-IV EDNOS and increased cases of specified eating disorders. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:578-581). © 2016 Wiley Periodicals, Inc.
O'Brien, Katie M; Whelan, Denis R; Sandler, Dale P; Weinberg, Clarice R
Eating disorders such as anorexia nervosa and bulimia nervosa affect overall and reproductive health and may also affect breast cancer risk. We studied the association between self-reported eating disorders and breast cancer risk in a prospective cohort study. In 2003-2009, the Sister Study enrolled women ages 35-74 years who had a sister with breast cancer but had never had it themselves. Using data from 47,813 women, we estimated adjusted HRs and 95% confidence intervals (CI) for the association between eating disorders and invasive breast cancer over a median of 5.4 years of follow-up. Three percent (n = 1,569) of participants reported a history of an eating disorder. Compared with women who never had an eating disorder, women who reported eating disorders in the past had reduced breast cancer risk (HR = 0.62; 95% CI, 0.42-0.92). In this large prospective, observational cohort study, we observed an inverse association between having a history of an eating disorder and invasive breast cancer. Historical eating disorders may be associated with a long-term reduction in breast cancer risk. Cancer Epidemiol Biomarkers Prev; 26(2); 206-11. ©2016 AACR. ©2016 American Association for Cancer Research.
Wilson, G. Terence; Fairburn, Christopher G.
Sees cognitive-behavioral therapy (CBT) as applicable to all eating disorders but most intensively studied in treatment of bulimia nervosa. Briefly reviews most commonly used cognitive treatments for eating disorders, provides critical evaluation of their effectiveness, and speculates about their mechanisms of action. Notes that CBT has not been…
Wilson, G. Terence; Grilo, Carlos M.; Vitousek, Kelly M.
Significant progress has been achieved in the development and evaluation of evidence-based psychological treatments for eating disorders over the past 25 years. Cognitive behavioral therapy is currently the treatment of choice for bulimia nervosa and binge-eating disorder, and existing evidence supports the use of a specific form of family therapy…
Ramirez, Maria E.; McIntosh, David E.; Kruczek, Theresa
Eating disorders, once thought to be exclusively a disorder of the more affluent Western countries, are now spreading around the world. Despite the wealth of information on the prevalence of eating disorders in developed countries, epidemiological data for South America is scarce. The 26-item Eating Attitude Test (EAT-26) was used to explore the…
Davidsen, Annika Helgadóttir; Lau, Marianne Engelbrecht
Researchers at the Stolpegaard Psychotherapy Centre are seeking to improve outcomes for patients with eating disorders by gathering their feedback on group psychotherapy sessions with the aim of optimising treatment.......Researchers at the Stolpegaard Psychotherapy Centre are seeking to improve outcomes for patients with eating disorders by gathering their feedback on group psychotherapy sessions with the aim of optimising treatment....
Wagener, Amy M.; Much, Kari
This article focuses on the complex nature of eating disorders, specifically highlighting their use as coping mechanisms for underlying emotional and psychological concerns. Case examples of college counseling center clients are discussed in order to illustrate common ways in which eating disorders are utilized by clients with varying…
Full Text Available This article reviews several most important evolutionary mechanisms that underlie eating disorders. The first part clarifies evolutionary foundations of mental disorders and various mechanisms leading to their development. In the second part selective pressures and evolved adaptations causing contemporary epidemic of obesity as well as differences in dietary regimes and life-style between modern humans and their ancestors are described. Concerning eating disorders, a number of current evolutionary explanations of anorexia nervosa are presented together with their main weaknesses. Evolutionary explanations of eating disorders based on the reproductive suppression hypothesis and its variants derived from kin selection theory and the model of parental manipulation were elaborated. The sexual competition hypothesis of eating disorder, adapted to flee famine hypothesis as well as explanation based on the concept of social attention holding power and the need to belonging were also explained. The importance of evolutionary theory in modern conceptualization and research of eating disorders is emphasized.
Peroutsi, A; Gonidakis, F
During the last 50 years, eating disorders have developed to a complicated and widespread medical and social issue. The latest research results indicate that eating disorders have a quite complicated and multifactorial etiology. According to the multifactorial etiological model, the impact of mass media can be regarded mainly as a precipitating factor. The literature review showed that mass media have a considerable impact on the development and perpetuation of eating disorders. Mass media contribute to the promotion of the thinness ideal as a way to achieve social approval, recognition and success. Mass media also promote dieting and food deprivation, as a successful way of life or as a socially agreeable practice. Furthermore, the literature review showed that mass media remain the main source of information about eating disorders. Considering the above result, mass media could play a major role in the promotion of prevention practices and early diagnosis and treatment of eating disorders.
The past few years have seen a steep increase in journal articles relating to feeding and eating disorders in children, making a succinct overview timely. The relevance of this review is enhanced by the recent publication of revised feeding and eating disorder diagnostic criteria in DSM-5. These have significant implications for younger patients, in particular through the inclusion of the new diagnostic category Avoidant/Restrictive Food Intake Disorder (ARFID). It is likely that this will encourage increased research interest in this field. Recent publications included in this article cover a broad range of topics relevant to childhood feeding and eating disorders, to include: presentation, diagnosis and classification; epidemiology; risk factors; assessment measures; treatment, prognosis and outcome. The area of feeding and eating disorders in children remains relatively under-researched, with significant gaps in knowledge about epidemiology, course and prognosis as well as a limited evidence base for treatment. However, important and promising avenues are increasingly being explored. In relation to clinical practice, there is now a much better recognition of these disorders and a greater awareness of their complexity, severity and potential impact in both the short and the longer term if not appropriately managed.
Dalle Grave, Riccardo
Eating disorders are common health problems afflicting mainly female adolescents and young women. They are associated with important physical health and psychosocial morbidity, and carry increased risk of death. Their cause is not yet completely understood and their management is complex, with some patients resisting all available treatments. AIMS OF THIS REVIEW: To provide the readers with an update regarding our knowledge and understanding of eating disorders. Medline database has been used for searching articles on eating disorders published since 1980. The key words used were eating disorders, anorexia nervosa, bulimia nervosa, bulimia, and binge eating. Professional books published during this period has been also reviewed. In the last 30 years a substantial improvement has been achieved both in the understanding and management of eating disorders, but many problems still need to be resolved. Three principal priorities should be addressed. First, the actual classification of eating disorders should be revised, since about half the cases seen in clinical practice receive a diagnosis of eating disorder not otherwise specified, and it is common to observe a migration between eating disorder diagnoses. Second, the research on pathogenesis should better clarify the exact role of genetic and environmental risk factors, and how they interact and vary across the development and maintenance of eating disorders. Third, there is an urgent need both to disseminate the few evidence-based treatments available, and to develop more potent treatments for all the eating disorder diagnostic categories. Copyright © 2010 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
Shaw, Heather; Stice, Eric; Becker, Carolyn Black
This article reviews eating disorder (ED) prevention programs, highlighting features that define successful programs and particularly promising interventions, and how they might be further refined. The field of ED prevention has advanced considerably both theoretically and methodologically compared with the earlier ED prevention programs, which were largely psychoeducational and met with limited success. Recent meta-analytic findings show that more than half (51%) of ED prevention interventions reduced ED risk factors and more than a quarter (29%) reduced current or future eating pathology (EP). A couple of brief programs have been shown to reduce the risk for future onset of EP and obesity. Selected interactive, multisession programs offered to participants older than 15 years, delivered by professional interventionists and including body acceptance or dissonance-induction content, produced larger effects. Understanding and applying these results can help inform the design of more effective prevention programs in the future.
Ciao, Anna C; Loth, Katie; Neumark-Sztainer, Dianne
Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors' descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research.
Ciao, Anna C.; Loth, Katie; Neumark-Sztainer, Dianne
Over the past two decades, the field of eating disorders has made remarkable strides in identifying, evaluating, and disseminating successful prevention programs. The current review identifies and discusses nine distinct eating disorders prevention programs that reduce existing eating disorder pathology or prevent the onset of future pathology. Each program was evaluated in one or more controlled trial with a follow-up period of at least six months. We review the evidence base for these nine successful programs and discuss their common and unique features. Based on authors’ descriptions of their programs in published trials, we found that all programs were theory-driven, targeted one or more eating disorder risk factor (e.g., body dissatisfaction), were delivered across multiple group sessions, and included at least some interactive content. Most programs included content related to healthy eating/nutrition, media literacy/sociocultural pressures, and body acceptance/body satisfaction. Notably, there was wide variation in some participant features (e.g., participant age, sex, risk status) and intervention features (e.g., setting and format, length and dose, providers), suggesting that a variety of programs are beneficial in impacting eating disorder pathology. Implications and directions for future research are discussed, including an increased focus on universal and indicated prevention programs, expanding programs to a wider age range and a broader spectrum of weight-related problems, and rigorous evaluation of programs through efficacy, effectiveness, and implementation research. PMID:24821099
Full Text Available Zeynep Yilmaz,1 J Andrew Hardaway,1 Cynthia M Bulik1–3 1Department of Psychiatry, 2Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Abstract: Eating disorders (EDs are serious psychiatric conditions influenced by biological, psychological, and sociocultural factors. A better understanding of the genetics of these complex traits and the development of more sophisticated molecular biology tools have advanced our understanding of the etiology of EDs. The aim of this review is to critically evaluate the literature on the genetic research conducted on three major EDs: anorexia nervosa, bulimia nervosa, and binge eating disorder. We will first review the diagnostic criteria, clinical features, prevalence, and prognosis of anorexia nervosa, bulimia nervosa, and binge eating disorder, followed by a review of family, twin, and adoption studies. We then review the history of genetic studies of EDs covering linkage analysis, candidate-gene association studies, genome-wide association studies, and the study of rare variants in EDs. Our review also incorporates a translational perspective by covering animal models of ED-related phenotypes. Finally, we review the nascent field of epigenetics of EDs and a look forward to future directions for ED genetic research. Keywords: anorexia nervosa, binge eating disorder, bulimia nervosa, animal models, genome-wide association studies, high-throughput sequencing
Eating disorders frequently appear during the teen years or in young adulthood. Common eating disorders include nervosa, bulimia nervosa and binge-eating disorder. Eating disorders affect both men and women. Keywords: eating disorders, children, adults, female athletes ...
Masheb, Robin M; Grilo, Carlos M
The current study examined emotional overeating in overweight patients with binge eating disorder (BED). A new measure--the Emotional Overeating Questionnaire (EOQ)--was developed to measure the frequency of overeating in response to emotions. The internal consistency, test-retest reliability, and factor structure of this measure were examined, and its associations with eating disorder psychopathology, depression, and gender were explored. Two hundred twenty consecutive overweight (body mass index [BMI] > or = 25) treatment-seeking BED patients (48 men and 172 women) were administered the EOQ, which assesses overeating frequency in response to six emotions (anxiety, sadness, loneliness, tiredness, anger, and happiness). A subset of patients (n = 83) completed the measure again approximately 1 week later. BMI was measured, and participants completed measures of eating disorder psychopathology. The EOQ was internally consistent (alpha =.85), its items were significantly and moderately correlated (range .32 to .70) with each other, and principal components analysis revealed one factor accounting for 58% of the variance. The EOQ items and total score were characterized by good test-retest reliability (intraclass correlation coefficients [ICCs] ranged from .62 to .73). Significant correlations were found between the emotional overeating items and total score, and binge frequency, eating disorder features, and depressive symptomatology. Emotional overeating was unrelated to BMI, and men and women reported similar rates of emotional overeating. Emotional overeating was significantly associated with binge frequency, eating disorder features, and depression, but was not related to BMI or gender.
Garfinkel, P E; Kennedy, S H; Kaplan, A S
To highlight developments in the taxonomy of eating disorders since Russell's original description of bulimia nervosa (BN) in 1979 and through 3 versions of the Diagnostic and Statistical Manual. Criteria for anorexia nervosa (AN), BN and binge eating disorder (BED) are systematically described. While criteria for AN remain largely unchanged between DSM-III-R and DSM-IV, the subclassification of binge/purge and restricter subgroups endorses previous research findings. For BN, the definition of "binge" has occupied considerable attention both in quantitative and qualitative terms. The arbitrary choice of 2 episodes per week as a minimum frequency is also discussed in light of recent data from the Ontario Health Supplement. A third eating disorder, BED, is now included in the appendix of DSM-IV under Eating Disorders--Not Otherwise Specified category. The potential overlap between this disorder and nonpurging BN is discussed. Finally, the relationship between eating disorders and other psychiatric disorders including depression, schizophrenia, obsessional, and conversion disorders is considered as well as the continuum from preoccupation with weight to eating disorder. While significant advances have been made in understanding and classifying eating disorders during the past 15 years, further empirical work is necessary to clarify areas of uncertainty.
Full Text Available Marilou DP Tromp,1 Anouk AMT Donners,1 Johan Garssen,1,2 Joris C Verster1,31Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands; 2Nutricia Research, Utrecht, the Netherlands; 3Center for Human Psychopharmacology, Swinburne University, Melbourne, VIC, AustraliaObjective: To investigate the relationship between eating disorders, body mass index (BMI, sleep disorders, and daytime functioning.Design: Survey.Setting: The Netherlands.Participants: N=574 Dutch young adults (18–35 years old.Measurements: Participants completed a survey on eating and sleep habits including the Eating Disorder Screen for Primary care (ESP and SLEEP-50 questionnaire subscales for sleep apnea, insomnia, circadian rhythm disorder (CRD, and daytime functioning. SLEEP-50 outcomes of participants who screened negative (≤2 and positive (>2 on the ESP were compared. In addition, SLEEP-50 scores of groups of participants with different ESP scores (0–4 and different BMI groups (ie, underweight, healthy weight, overweight, and obese were compared using nonparametric statistics.Results: Almost 12% (n=67 of participants screened positive for having an eating disorder. Relative to participants without eating disorders, participants who screened positive for eating disorders reported significantly higher scores on sleep apnea (3.7 versus 2.9, P=0.012, insomnia (7.7 versus 5.5, P<0.0001, CRD (2.9 versus 2.3, P=0.011, and impairment of daytime functioning (8.8 versus 5.8, P=0.0001. ESP scores were associated with insomnia (r=0.117, P=0.005, sleep apnea (r=0.118, P=0.004, sleep quality (r=−0.104, P=0.012, and daytime functioning (r=0.225, P<0.0001, but not with CRD (r=0.066, P=0.112. BMI correlated significantly with ESP scores (r=0.172, P<0.0001 and scores on sleep apnea (r=0.171, P<0.0001. When controlling for BMI, the partial correlation between ESP and sleep apnea remained significant (r=0.10, P=0.015.Conclusion
Most twin studies suggest a heritability of SO to 80% for liability to eating disorders. At least moderate heritability is further supported by family and adoption studies. Polymorphisms of the 5-HT2A and BDNF genes appear robust candidates for anorexia nervosa and bulimia nervosa, while linkage studies suggest loci for anorexia nervosa in chromosome 1 and a locus in chromosome 10 for bulimia nervosa. Contemporary Western culture has a salient role in the rising incidence of eating disorders, and epigenetic mechanisms are suggested to be involved. In the near future, GWAS will likely provide compelling new data of genetic etiology and mechanisms of eating disorders.
Romero-Martínez, Ángel; Ruiz-Robledillo, Nicolás; Moya-Albiol, Luis
Caring for children diagnosed with a chronic psychological disorder such as an eating disorder (ED) can be used as a model of chronic stress. This kind of stress has been reported to have deleterious effects on caregivers' cognition, particularly in verbal declarative memory of women caregivers. Moreover, high depressive mood and variations in testosterone (T) levels moderate this cognitive decline. The purpose of this study was to characterize whether caregivers of individuals with EDs (n = 27) show declarative memory impairments compared to non-caregivers caregivers (n = 27), using for this purpose a standardized memory test (Rey's Auditory Verbal Learning Test). Its purpose was also to examine the role of depressive mood and T in memory decline. Results showed that ED caregivers presented high depressive mood, which was associated to worse verbal memory performance, especially in the case of women. In addition, all caregivers showed high T levels. Nonetheless, only in the case of women caregivers did T show a curvilinear relationship with verbal memory performance, meaning that the increases of T were associated to the improvement in verbal memory performance, but only up to a certain point, as after such point T continued to increase and memory performance decreased. Thus, chronic stress due to caregiving was associated to disturbances in mood and T levels, which in turn was associated to verbal memory decline. These findings should be taken into account in the implementation of intervention programs for helping ED caregivers cope with caregiving situations and to prevent the risk of a pronounced verbal memory decline.
Stella Maris Valiensi
Full Text Available El zolpidem es una droga hipnótica utilizada para el tratamiento del insomnio. Disminuye la latencia del sueño, el número total de despertares y aumenta el tiempo total del sueño respetando en general su arquitectura. Se cree que aumenta la fase 3 del sueño lento profundo. Nuestro objetivo es comunicar 8 casos de síndrome de ingesta nocturna relacionado al sueño y conductas automáticas complejas asociadas a sonambulismo como efecto colateral del zolpidem. Se analizaron las historias clínicas de 8 pacientes tratados con zolpidem que referían ingesta nocturna de alimentos con amnesia total o parcial del episodio. Se presentan 6 mujeres y 2 hombres, entre 32 y 72 años (media: 58 años, 7 tratados con zolpidem 10 mg/noche y 1 con zolpidem 12.5 mg/noche de liberación prolongada. El tiempo de exposición previo al desarrollo de eventos fue de 1 a 180 días (media de 39.8. El número de episodios relatados era de 1 a 8/noche (media 2.5 asociado con amnesia. Los episodios desaparecieron por completo en el 100% de los casos al suspender la medicación. El síndrome de ingesta nocturna relacionado al sueño es una parasomnia de sueño lento profundo que consiste en episodios de ingesta de alimento o bebida durante la noche, con amnesia parcial o completa del episodio. El zolpidem podría inducir el síndrome de ingesta nocturna relacionado al sueño en aproximadamente el 1% de pacientes, aunque creemos que es un efecto adverso que está subdiagnosticado. Se resuelve simplemente suspendiendo la medicación.Zolpidem is a hypnotic drug used in sleep disorders. It binds selectively to alpha 1 subunit of the GABA A benzodiazepine receptor. Zolpidem reduces sleep latency, number of arousals and increases the total time of sleep. However, it is considered that it may increase phase 3 of non rapid eye movement sleep, where somnambulism can take place. Our aim is to report 8 cases of sleep related eating disorders associated with the use of this drug
Allan, Steven; Goss, Ken
To test for differences between diagnostic groups on the severity of eating disorder beliefs and behaviours, evaluate the clinical significance of such differences, and assess the extent to which these beliefs and behaviours may be present at clinically significant levels across eating disorder diagnoses. 136 adult women outpatients (aged 18-65, with a BMI over 15) were diagnosed with an eating disorder and completed the Stirling Eating Disorder Scale. The expected pattern of statistically significant differences was found between diagnostic groups on anorexic dietary beliefs and behaviours and bulimic dietary beliefs and behaviours. A high percentage of participants in each diagnostic group scored above the clinical cut-off on the eating disorder belief and behaviour measures and a very high percentage of participants in each group reported clinically significant levels of restricting beliefs. Transdiagnostic or functional analytic approaches to treatment planning may lead to more effective interventions than current, diagnostically-based, care pathways. The high prevalence of restricting beliefs reported suggested that this may need to be a key focus for intervention for the majority of individuals presenting with an eating disorder. © 2013.
Watson, Hunna J; Zerwas, Stephanie; Torgersen, Leila; Gustavson, Kristin; Diemer, Elizabeth W; Knudsen, Gun Peggy; Reichborn-Kjennerud, Ted; Bulik, Cynthia M
Previous studies of the relationship between maternal eating disorders and adverse perinatal outcomes have failed to control for familial transmission of perinatal phenotypes, which may confound the reported association. In a unique design afforded by the Norwegian Mother and Child Cohort Study and Medical Birth Registry of Norway, we linked three generations through birth register records and maternal-reported survey data to investigate whether maternal eating disorders increase risk after parsing out the contribution of familial transmission of perinatal phenotypes. The samples were 70,881 pregnancies in grandmother-mother-child triads for analyses concerning eating disorder exposure during pregnancy and 52,348 for analyses concerning lifetime maternal eating disorder exposure. As hypothesized, eating disorders predicted a higher incidence of perinatal complications even after adjusting for grandmaternal perinatal phenotypes. For example, anorexia nervosa immediately prior to pregnancy was associated with smaller birth length (relative risk = 1.62; 95% CI [1.20, 2.14]), bulimia nervosa with induced labor (relative risk = 1.21; 95% CI [1.07, 1.36]), and binge-eating disorder with several delivery complications, larger birth length (relative risk = 1.25; 95% CI [1.17, 1.34]), and large-for-gestational-age (relative risk = 1.04; 95% CI [1.01, 1.06]). Maternal pregravid body mass index and gestational weight mediated most associations. Our results support that exposure to eating disorders increases the risk for negative health outcomes in pregnant women and their babies. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Johnson, L B; Boyd, L D; Rainchuso, L; Rothman, A; Mayer, B
The aim of this study was to assess the oral health knowledge among professionals who specialize in treating eating disorders, and identify to what extent their education, and training addresses oral health care delivery, and recommendations for individuals with eating disorders. Participants for this study were licensed behavioural and medical providers specializing in eating disorder treatment (n = 107), and recruited through professional eating disorder organizations. Participants completed an anonymous, online questionnaire (33 items) assessing level of oral health-related education, knowledge and treatment recommendations within the participant's respective eating disorder discipline. The majority of respondents (85%) were formally trained in eating disorders, and of those trained, 64.4% were not satisfied with the level of oral health education during formal education, and 19.5% report no oral health education. Respondents consider their knowledge of risk of oral disease for their clients/patients as average or above (84%), and ranked tooth erosion as the greatest reason for oral care (63%) while dry mouth led in the rankings for least significant reason for oral care (33%). Referral for oral care was found to be more common after reports of complication (55%). According to these findings, eating disorder professionals regard oral health care for their clients as significant, and may be unaware of associated oral risk factors, current oral care standards and long-term oral effects of disordered eating apart from enamel erosion. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Tasca, Giorgio A; Balfour, Louise
Attachment insecurity may confer risk for developing an eating disorder. We describe domains of attachment functioning that are relevant to eating disorders including: affect regulation, interpersonal style, coherence of mind, and reflective functioning. Research since 2000 on attachment and eating disorders related to these domains is reviewed. We searched MedLine/Pubmed and PsycINFO from January 2000 to February 2014 and kept articles that: were empirical, included adults with a diagnosed eating disorder, and used a standard attachment measure. We retained 50 relevant studies. Compared to controls, those with eating disorders had higher levels of attachment insecurity and disorganized mental states. Lower reflective functioning was specifically associated with anorexia nervosa. Attachment anxiety was associated with eating disorder symptom severity, and this relationship may be mediated by perfectionism and affect regulation strategies. Type of attachment insecurity had specific negative impacts on psychotherapy processes and outcomes, such that higher attachment avoidance may lead to dropping out and higher attachment anxiety may lead to poorer treatment outcomes. Research to date suggests a possible relationship between attachment insecurity and risk for an eating disorder. More research is needed that uses attachment interviews, and longitudinal and case control designs. Clinicians can assess attachment insecurity to help inform therapeutic stances and interventions. © 2014 Wiley Periodicals, Inc.
Bardone-Cone, Anna M.; Sturm, Katrina; Lawson, Melissa A.; Robinson, D. Paul; Smith, Roma
Objective This study examined perfectionism in relation to recovery from eating disorders by comparing different conceptualizations of perfectionism across healthy controls and fully recovered, partially recovered, and active eating disorder cases, where full recovery was defined using physical, behavioral, and psychological indices. Method Participants were primarily young adult females; 53 active eating disorder cases, 15 partially recovered cases, 20 fully recovered cases, and 67 healthy controls. Participants completed questionnaires assessing trait perfectionism, perfectionistic self-presentation style, and frequency of perfectionism cognitions, as well as a diagnostic interview to determine lifetime and current eating disorder diagnoses. Results A robust pattern emerged whereby the fully recovered eating disorder individuals and healthy controls had similar levels of perfectionism that were significantly lower than the perfectionism levels of the partially recovered and active eating disorder individuals, who were comparable to each other. Conclusion These findings have implications for more clearly defining eating disorder recovery and for the role perfectionism may play in achieving full recovery. PMID:19308994
Patel, Dilip R.; Greydanus, Donald E.; Pratt, Helen D.; Phillips, Elaine L.
Reviews research on eating disorders in adolescent athletes, including prevalence, its uncommonness among male athletes, risk factors, medical complications, prevention strategies, and implications for sport and exercise participation, management, and prognosis. (EV)
Koefoed, Maja Schølarth; Clausen, Loa; Rokkedal, Kristian
Objective In general eating disorder pathology in men shows more similarities than differences compared to women though with an overall lower level of pathology. In community studies men have been found to have more excessive exercise and more binge eating and in clinical populations men have been...... found to have more vomiting. Eating Disorder Examination (EDE) is “the golden standard” of diagnostic interviewing in eating disorder but analysis of gender differences in scores on the EDE have never been reported. The present study aim to explore gender differences on the EDE among adolescents...
Ágh, Tamás; Kovács, Gábor; Supina, Dylan; Pawaskar, Manjiri; Herman, Barry K; Vokó, Zoltán; Sheehan, David V
To perform a systematic review of the health-related quality of life (HRQoL) and economic burdens of anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). A systematic literature search of English-language studies was performed in Medline, Embase, PsycINFO, PsycARTICLES, Academic Search Complete, CINAHL Plus, Business Source Premier, and Cochrane Library. Cost data were converted to 2014 Euro. Sixty-nine studies were included. Data on HRQoL were reported in 41 studies (18 for AN, 17 for BN, and 18 for BED), on healthcare utilization in 20 studies (14 for AN, 12 for BN, and 8 for BED), and on healthcare costs in 17 studies (9 for AN, 11 for BN, and only 2 for BED). Patients' HRQoL was significantly worse with AN, BN, and BED compared with healthy populations. AN, BN, and BED were associated with a high rate of hospitalization, outpatient care, and emergency department visits. However, patients rarely received specific treatment for their eating disorder. The annual healthcare costs for AN, BN, and BED were €2993 to €55,270, €888 to €18,823, and €1762 to €2902, respectively. AN, BN, and BED have a serious impact on patient's HRQoL and are also associated with increased healthcare utilization and healthcare costs. The burden of BED should be examined separately from that of BN. The limited evidence suggests that further research is warranted to better understand the differences in long-term HRQoL and economic burdens of AN, BN, and BED.
O. N. Komarova
Full Text Available Eating disorder is observed in infants at different developmental stages. This condition may be caused by comorbidities, organic diseases, or psychogenic causes. After birth, a child’s eating behavior evolves, which largely depends on the relations arising between him, his mother, and other family members. Eating disorders may be caused by an impaired child-mother relationship: inadequate maternal behavior, excessive or poor parenteral attention. The treatment of eating disorders involves a comprehensive approach, including behavioral and dietary correction that is considered in this paper.
DerMarderosian, Diane; Chapman, Heather A; Tortolani, Christina; Willis, Matthew D
Eating disorders are a group of psychiatric disorders with potentially fatal medical complications. Early integrated care including the family as well as pediatric medicine, nutrition, psychology and psychiatry is critical for improving prognosis and limiting negative outcomes. Mental health services are a critical component of treatment; timely weight restoration maximizes efficacy. Despite being relatively common, there are many misperceptions about eating disorders, their severity, and the associated morbidity and mortality. Opportunities exist within the medical and psychiatric communities for a better understanding of the complexity of diagnosing and treating patients with eating disorders. Copyright © 2017 Elsevier Inc. All rights reserved.
Ruscitti, Catherine; Rufino, Katrina; Goodwin, Natalie; Wagner, Rebecca
Background A defining characteristic of eating disorders (EDs) is difficulty with emotion regulation (ER). Previous research indicates that ED subtypes demonstrate differing ER difficulties. Specifically, individuals with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) show greater impairment in their ability to regulate emotions in areas such as achieving goals while upset, reacting impulsively to distress, and effectively using coping strategies, as compared to those with Binge Eating Disorde...
Ward, A.; Troop, N.; Cachia, M.; Watkins, P.; Treasure, J.
We present a series of patients with both an eating disorder and diabetes mellitus and compare these to a group of non-diabetic patients from the same clinic. Significantly more of the diabetic patients had previous attempts at treatment for their eating disorder. A high incidence of diabetic complications was noted with clear implications, both clinically and economically, for early intervention. The incidence of childhood trauma was lower in the diabetic than the non-diabetic group. In the ...
Full Text Available Caring for children diagnosed with a chronic psychological disorder such as an eating disorder (ED can be used as a model of chronic stress. This kind of stress has been reported to have deleterious effects on caregivers’ cognition, particularly in verbal declarative memory of women caregivers. Moreover, high depressive mood and variations in testosterone (T levels moderate this cognitive decline. The purpose of this study was to characterize whether caregivers of individuals with EDs (n = 27 show declarative memory impairments compared to non-caregivers caregivers (n = 27, using for this purpose a standardized memory test (Rey’s Auditory Verbal Learning Test. Its purpose was also to examine the role of depressive mood and T in memory decline. Results showed that ED caregivers presented high depressive mood, which was associated to worse verbal memory performance, especially in the case of women. In addition, all caregivers showed high T levels. Nonetheless, only in the case of women caregivers did T show a curvilinear relationship with verbal memory performance, meaning that the increases of T were associated to the improvement in verbal memory performance, but only up to a certain point, as after such point T continued to increase and memory performance decreased. Thus, chronic stress due to caregiving was associated to disturbances in mood and T levels, which in turn was associated to verbal memory decline. These findings should be taken into account in the implementation of intervention programs for helping ED caregivers cope with caregiving situations and to prevent the risk of a pronounced verbal memory decline.
Bertoli, Simona; Spadafranca, Angela; Bes-Rastrollo, Maira; Martinez-Gonzalez, Miguel Angel; Ponissi, Veronica; Beggio, Valentina; Leone, Alessandro; Battezzati, Alberto
The key factors influencing the development of Binge Eating Disorder (BED) are not well known. Adherence to the Mediterranean diet (MD) has been suspected to reduce the risk of several mental illnesses such as depression and anxiety. There are no existing studies that have examined the relationships between BED and MD. Cross-sectional study of 1472 participants (71.3% women; mean age: 44.8 ± 12.7) at high risk of BED. A MD score (MED-score) was derived from a validated food frequency questionnaire and BED by Binge Eating Scale questionnaire (BES). Body mass index, waist circumference and total body fat (%) were assessed by anthropometric measurements. 376 (25.5%) cases of self reported BED were identified. 11.1% of participants had a good adherence to MD (MED-score ≥ 9). After adjustments for age, gender, nutritional status, education, and physical activity level, high MED-score was associated with lower odds for BED (odds ratios and 95% confidence intervals of a BED disorder for successive levels of MED-score were 1 (reference), 0.77 (0.44, 1.36), 0.66 (0.37, 1.15), 0.50 (0.26, 0.96), and 0.45 (0.22, 0.55) (P for trend: depression and anxiety on MED-score in binge eaters. These results demonstrate an inverse association between MD and the development of BED in a clinical setting among subjects at risk of BED. Therefore, we should be cautious about generalizing the results to the whole population, although reverse causality and confounding cannot be excluded as explanation. Further prospective studies are warranted. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
Spoor, Sonja T P; Bekker, Marrie H J; Van Heck, Guus L; Croon, Marcel A; Van Strien, Tatjana
This study investigated the associations of appearance orientation and eating disorder symptoms with internal body awareness in an eating-disordered group of women and a general sample of women. In the eating-disordered group, appearance orientation was positively associated with internal body awareness. Eating disorders symptoms were negatively related to the awareness of bodily signals. No significant associations were found in the general sample of women. The results indicate that in eating-disordered individuals preoccupation with the body and eating-disordered behaviors are not only negatively associated with hunger, but with awareness of other bodily signals as well.
Kass, Andrea E; Kolko, Rachel P; Wilfley, Denise E
This review summarizes recent evidence on psychological treatments for eating disorders. Eating disorders are serious psychiatric conditions requiring evidence-based intervention. Treatments have been evaluated within each eating disorder diagnosis and across diagnoses. For adults with anorexia nervosa, no one specialist treatment has been shown to be superior. Cognitive behavioral therapy and interpersonal psychotherapy remain the most established treatments for bulimia nervosa and binge eating disorder, with stepped-care approaches showing promise and new behavioral treatments under study. Enhanced cognitive behavioral therapy has improved symptoms in adults and youth. Maudsley family-based therapy is the most established treatment for youth with anorexia nervosa and may be efficacious for youth with bulimia nervosa. Interpersonal psychotherapy for the prevention of excess weight gain may be efficacious for reducing loss of control eating and weight gain in overweight youth. Significant advances in treatments have been made, including evaluation of long-term outcomes, novel approaches, and tailored extension for specific patient profiles. However, widespread access to effective eating disorder treatments remains limited. Increasing the potency and expanding the implementation of psychological treatments beyond research settings into clinical practice has strong potential to increase access to care, thereby reducing the burden of eating disorders.
Castellini, Giovanni; Fioravanti, Giulia; Ravaldi, Claudia; Masetti, Sara; Vannacci, Alfredo; Mannucci, Edoardo; Faravelli, Carlo; Ricca, Valdo
Eating disorders (EDs) are an important cause of physical morbidity and psychosocial impairment, and eating disordered patients have a worse quality of life than peers. The aim of this study was to develop and validate a new self-report instrument, the Eating Disorders Well Being Questionnaire (EDwell), a measure of eating disorders-related quality of life, which takes into consideration not only the intensity, but also the subjective relevance of physical and psychosocial distress. The questionnaire was administered to 120 eating disordered patients and 60 healthy controls. Patients underwent a psychopathological and clinical evaluation. Test-retest reliability, internal consistency, and psychopathological correlates were evaluated. All patients were also administered the Eating Disorder Examination (EDE12.0D) and the Short Form 36 Health Survey (SF36). A factor analysis was performed to verify the distribution of items into subscales. EDwell showed good test-retest reliability and internal consistency. EDwell scores significantly correlated with EDE12.0D total and subscale scores. A significant correlation was also found between several EDwell and SF36 scores. Factor analysis identified three factors: Perfectionism/Control, Loneliness/Avoidance, Social Functioning. The EDwell questionnaire is a feasible and reliable measure of the specific impact of Eating Disorders psychopathology on quality of life.
Herpertz, S; Albus, C; Lohff, S; Michalski, K; Masrour, M; Lichtblau, K; Köhle, K; Mann, K; Senf, W
As part of a multicentre study on the comorbidity of diabetes mellitus and eating disorders, the following paper compares the psychological features of diabetic patients with and without an eating disorder. In a sample of 663 diabetic patients (type 1: n = 341 type 2: n = 322), eating disorder related variables, self-esteem, body acceptance and emotional distress, especially depression in diabetic patients with and without an eating disorder, were compared. A possible relationship to diabetic control was investigated. Type 2 diabetics revealed more pronounced psychopathology in comparison to type 1 diabetics. According to our assumption, diabetic patients with an eating disorder and diabetic patients who deliberately reduced insulin in order to loose weight (insulin purging) revealed a much more severe psychopathology compared to diabetics without an eating disorder. The type of diabetes was of no importance. With the exception of the variable body and figure satisfaction in the sample of type 1 diabetes and the variable self-acceptance in the sample of type 2 diabetes, no relationship to diabetic control could be found.
Tagay, Sefik; Düllmann, Sonja; Schlegl, Sandra; Nater-Mewes, Ricarda; Repic, Nevena; Hampke, Christian; Brähler, Elmar; Gerlach, Gabriele; Senf, Wolfgang
The aim of the present prospective-naturalistic study was the evaluation of psychosomatic inpatient treatment for anorexia nervosa (AN) and bulimia nervosa (BN). 128 patients with eating disorders (n=59 AN and n=69 BN) were investigated on admission and discharge using the following standardized questionnaires: eating disorder symptoms (EDI), general psychopathology (BSI), quality of life (SF-12), and personal resources (SOC-13, SWE). Moderate to large effect sizes were achieved for the eating disorder symptoms; in addition, general psychopathology was substantially reduced at the end of treatment, and quality of life as well as personal resources were enhanced. Personal resources were found to be the strongest predictors for therapy outcome. Based on our data, important insights and recommendations may be gained for the inpatient treatment of eating disorders, especially with regard to the potential influence of personal resources. © Georg Thieme Verlag KG Stuttgart · New York.
Crino, Natalie; Touyz, Stephen; Rieger, Elizabeth
The present study compared the use (and effectiveness) of cognitive self-regulation strategies in eating disordered (ED) and non-eating disordered women (non-ED), and whether ED subgroups differ in their use of avoidant/suppressive strategies and cognitive reappraisal. The participants consisted of 90 adult patients recruited from a specialist eating disorder service and 97 adults without an ED. Cognitive self-regulation strategies were examined on a baseline self-report measure and while looking in a mirror. The results of this study showed that, relative to the non-ED group, ED participants engage in more worry and self-punishment and less distraction and social control strategies in general but not specifically during a body exposure task. Reappraisal strategies were equally likely to be used by clinical and non-clinical groups but participants with anorexia nervosa (AN) found them less effective during the task. Non-ED participants found distraction strategies more effective than the ED group for managing the body exposure experience. ED subgroups used avoidant/suppressive strategies and cognitive reappraisal strategies to a similar extent. The use of maladaptive self-regulation strategies, and the use and effectiveness of some of the more adaptive self-regulation strategies sets eating disorders apart from those without an eating disorder, supporting previous research in the area. Contrary to what was predicted, the results were similar across ED subgroups. The findings highlight the importance of cognitive self-regulation strategies as a focus of research and clinical intervention. Level III: Case-control study.
Keel, Pamela K; Brown, Tiffany A
To review recent studies describing eating disorder course and outcome. Electronic and manual searches were conducted to identify relevant articles published since 2004. Twenty-six articles were identified. For anorexia nervosa (AN), most patients ascertained through outpatient settings achieved remission by 5-year follow-up. Inpatient treatment predicted poor prognosis as inpatient samples demonstrated lower remission rates. Outcome differed between bulimia nervosa (BN) and eating disorders not otherwise specified (EDNOS), including binge eating disorder (BED), for shorter follow-up durations; however, outcomes appeared similar between BN and related EDNOS by 5-year follow-up. Greater psychiatric comorbidity emerged as a significant predictor of poor prognosis in BN, whereas few prognostic indicators were identified for BED or other EDNOS. Results support optimism for most patients with eating disorders. However, more effective treatments are needed for adult AN inpatients and approximately 30% of patients with BN and related EDNOS who remain ill 10-20 years following presentation.
Alba, Patricio; Kes, Mariana Gabriela
Eating disorders are a growing problem in healthcare. Altered eating behaviors are a consequence of cognitions and emotions generated by low self-esteem and dissatisfaction with body image and schema. It is possible, that a negative body image, and in many cases, distorted, may be the most difficult feature to approach and improve in this disorders. But the dissatisfaction to one's own body would not be related only to altered eating behaviors. Several studies show that body image and one's own body perception are an essential feature in sexual experiences, especially in women's sexuality. This article describes the relation and influences between body image and women's sexuality, and the sexuality in women with eating disorders.
Wilson, G Terence; Shafran, Roz
January, 2004, marked the publication of NICE guidelines for the treatment of eating disorders, a series of recommendations from a multidisciplinary, comprehensive, and rigorous process. The recommendations are assigned a grade from A (strong empirical support from well-conducted randomised trials) to C (expert opinion without strong empirical data). Over 100 recommendations were made, most of which were given a C grade. No specific recommendations were made for anorexia nervosa. Cognitive behavioural therapy for bulimia nervosa was assigned grade A because of the evidence showing that it is superior to other psychological and drug treatments. Antidepressants for bulimia nervosa were given grade B. No specific recommendations were made for atypical eating disorders except for binge-eating disorder (cognitive behavioural therapy was recommended [A]). The methodological rigour of the NICE guidelines is in contrast with the current Practice Guideline for Eating Disorders (PGED) of the American Psychiatric Association. PGED does not detail criteria for evaluating supporting research. Instead of making clear recommendations, PGED is uncritically inclusive and emphasises subjective judgment of individual clinicians. The NICE guidelines balance recommending specific treatments against the importance of clinical judgment when guideline recommendations are not readily applicable. Evidence-based guidelines are limited by the quality of the available research and its clinical relevance. The NICE guidelines underscore the absence of sufficient evidence for guidance in several important areas, such as atypical eating disorders (eating disorders not otherwise specified) which are the most common. Research on the treatment of these atypical eating disorders is needed. Evidence-based psychological treatments are not routinely implemented in general practice. Dissemination of these demonstrably effective treatments poses a challenge, and learning how to implement evidence
Son, G.E. van; Hoeken, D. van; Bartelds, A.I.M.; Furth, E.F. van; Hoek, H.W.
The link between degree of urbanisation and a number of mental disorders is well established. Schizophrenia, psychosis and depression are known to occur more frequently in urban areas. In our primary care-based study of eating disorders, the incidence of bulimia nervosa showed a dose response relation with degree of urbanisation and was five times higher in cities than in rural areas. Remarkably, anorexia nervosa showed no association with urbanisation. We conclude that urbanlife is a potenti...
textabstractEating disorders (EDs) are rare, but very serious psychiatric disorders, with a low recovery rate (1,2). This warrants studies on treatment quality to improve the course and consequences of EDs and enhance recovery rates. Despite the increasing recognition of the value of patient input, few studies address how ED patients evaluate the illness, its consequences and treatment, and how their views are related to scientific evidence and expert opinions.
Elisaveta Pavlova; Mariana Arnaoudova; Ivan Aleksandrov; Yasen Yanev
Background: Eating Disorders (EDs) are characterized by a persistent disturbance of eating or eating-related behavior that significantly impairs physical health or psychosocial functioning. EDs are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Their epidemiology is rising for the past decades, and EDs affect all races, social levels and both genders. Due to the long and expensive treatment, chronic course, and the fact that most of the ...
Bulik, Cynthia M; Von Holle, Ann; Gendall, Kelly; Kveim Lie, Kari; Hoffman, Elizabeth; Mo, Xiaofei; Torgersen, Leila; Reichborn-Kjennerud, Ted
We explored sex ratio at birth, defined as the proportion of male live births, in women with anorexia nervosa, bulimia nervosa, binge eating disorder, and eating disorders not otherwise specified-purging type (EDNOS-P) relative to a referent group in a large population based sample of 38,340 pregnant women in Norway. Poisson regressions were adjusted for mother’s age, pre-pregnancy BMI, lifetime smoking status, maternal education, income, marital status, gestational age, and parity. Lower pro...
Bartholdy, Savani; Rennalls, Samantha J.; Jacques, Claire; Danby, Hollie; Campbell, Iain C.; Schmidt, Ulrike; O?Daly, Owen G.
Altered inhibitory control has been implicated in the development and maintenance of eating disorders (ED), however it is unclear how different types of inhibitory control are affected across the EDs. We explored whether individuals with bulimia nervosa (BN), binge eating disorder (BED) and anorexia nervosa (AN) differed from healthy individuals (HC) on two types of motor inhibitory control: proactive inhibition (related to the preparation/initiation of a response) and reactive inhibition (wi...
Díaz-Marsa, M; Lozano, C; Herranz, A S; Asensio-Vegas, M J; Martín, O; Revert, L; Saiz-Ruiz, J; Carrasco, J L
This work describes the rational bases justifying the use of acute tryptophan depletion technique in eating disorders (ED) and the methods and design used in our studies. Tryptophan depletion technique has been described and used in previous studies safely and makes it possible to evaluate the brain serotonin activity. Therefore it is used in the investigation of hypotheses on serotonergic deficiency in eating disorders. Furthermore, and given the relationship of the dysfunctions of serotonin activity with impulsive symptoms, the technique may be useful in biological differentiation of different subtypes, that is restrictive and bulimic, of ED. 57 female patients with DSM-IV eating disorders and 20 female controls were investigated with the tryptophan depletion test. A tryptophan-free amino acid solution was administered orally after a two-day low tryptophan diet to patients and controls. Free plasma tryptophan was measured at two and five hours following administration of the drink. Eating and emotional responses were measured with specific scales for five hours following the depletion. A study of the basic characteristics of the personality and impulsivity traits was also done. Relationship of the response to the test with the different clinical subtypes and with the temperamental and impulsive characteristics of the patients was studied. The test was effective in considerably reducing plasma tryptophan in five hours from baseline levels (76%) in the global sample. The test was well tolerated and no severe adverse effects were reported. Two patients withdrew from the test due to gastric intolerance. The tryptophan depletion test could be of value to study involvement of serotonin deficits in the symptomatology and pathophysiology of eating disorders.
Bowden, David J; Kilburn-Toppin, Fleur; Scoffings, Daniel J
Eating disorders are a major challenge for health professionals, with many patients receiving ineffective care due to underdiagnosis or poor compliance with treatment. The incidence of eating disorders is increasing worldwide, producing an increasing burden on healthcare systems, and they most often affect young patients, with significant long-term complications. The effects of long-term malnutrition manifest in almost every organ system, and many can be detected radiologically, even without overt clinical findings. Musculoskeletal complications including osteoporosis result in a high incidence of insufficiency fractures, with long-term implications for bone health and growth, while respiratory complications are often recognized late due to disordered physiologic responses to infection. Gastrointestinal complications are numerous and in extreme cases may result in fatal outcomes after acute gastric dilatation and rupture subsequent to binge eating. In patients with severely disordered eating, in particular anorexia nervosa, marked derangement of electrolyte levels may result in refeeding syndrome, which requires emergent management. Recognition of such complications is critical to effective patient care and requires radiologists to be aware of the spectrum of imaging abnormalities that may be seen. Since many patients are reluctant to disclose their underlying condition, radiologists also play a critical role in identifying previously undiagnosed eating disorders. ©RSNA, 2013.
Tetley, Amanda; Moghaddam, Nima G; Dawson, David L; Rennoldson, Mike
This article systematically reviewed studies of parental bonding in people with eating disorders. MEDLINE, PsychINFO, EMBASE and CINAHL were searched to identify studies that compared parental bonding in people diagnosed with an eating disorder relative to non-clinical controls. Twenty-four studies were identified. Women with eating disorders typically reported lower parental care and higher parental protection compared to non-clinical, but not psychiatric, controls. Interestingly, a modest number of studies found that these relationships were mediated by avoidant problem solving style and several schemas from the Young Schema Questionnaire (YSQ; Schmidt, Joiner, Young, & Telch, 1995). While there are methodological limitations associated with the reviewed studies, they do offer some support for the proposal that difficulties in parent-child relationships predispose women to eating disorders and other psychiatric diagnoses. © 2013.
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Background: Our aim was to study the relationship between hormonal disturbances and psychopathology in Eating Disorders (ED.
Methods: Forty-nine women diagnosed as Eating Disorders according to DSM-IV were subjected to control plasma levels of TSH, FT3, FT4, LH, FSH, 17beta-estradiol, prolactin, cortisol, DHEAS, GH and IGF-1. They were also administered by SCL-90R, BAT, DES II questionnaires. We applied multivariate regression models.
Results: Our results highlight a statistically significant relation between LH, FSH and prolactin decreased levels, mood and thought disturbances (subscales 3, 5, 7, 8 and 9 of SCL-90r which are associated to Body Attitude ( BAT total scale and Dissociative Experiences (DES II total scale.
Conclusions: Decreased sexual hormones levels could have a role in ED psychological disturbances, not inquired yet
Fursland, Anthea; Watson, Hunna J
Eating disorders are common but underdiagnosed illnesses. Help-seeking for co-occurring issues, such as anxiety and depression, are common. To identify the prevalence of eating problems, using the SCOFF, and eating disorders when screening positive on the SCOFF (i.e., ≥2), among patients seeking help for anxiety and depression at a community-based mental health service. Patients (N = 260) consecutively referred and assessed for anxiety and depression treatment were administered the SCOFF screening questionnaire and a semi-structured standardized diagnostic interview during routine intake. 18.5% (48/260) scored ≥2 on the SCOFF, indicating eating problems. Of these, 41% (19/48) met criteria for an eating disorder. Thus, overall, 7.3% (19/260) of the sample met criteria for a DSM-IV eating disorder. Those scoring ≥2 on the SCOFF were more likely to: be female (p = 0.001), younger (p = 0.003), and have a history of self-harm (p eating disorders are a hidden phenomenon in general outpatient mental health. By using a standardized diagnostic interview to establish diagnosis rather than self- or staff-report, the study builds on limited previous findings. The naturalistic study setting shows that screening for eating disorders can be easily built into routine intake practice, and successfully identifies treatment need. Copyright © 2013 Wiley Periodicals, Inc.
Eating disorders, which include anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified, are psychiatric disorders with physical complications. Several factors may contribute to the onset of anorexia nervosa and bulimia nervosa, including a familial predisposition to these disorders as well as individual personality characteristics. Dissatisfaction with body shape and an overwhelming desire to be thin are considered as risk factors for the development of eating disorders. Skin signs are the expression of the medical consequences of starvation, vomiting, abuse of drugs, such as laxatives and diuretics, and psychiatric morbidity. They include xerosis, lanugolike body hair, telogen effluvium, carotenoderma, acne, hyperpigmentation, seborrheic dermatitis, acrocyanosis, perniosis, petechiae, livedo reticularis, interdigital intertrigo, paronychia, acquired striae distensae, and acral coldness. The most characteristic cutaneous sign of vomiting is Russell sign (knuckle calluses). Symptoms due to laxative or diuretic abuse include adverse reactions to drugs. Symptoms due to psychiatric morbidity (artefacta) include the consequences of self-induced trauma. The role of the dermatologist in the management of eating disorders is to make an early diagnosis of the "hidden" signs of eating disorders in patients who tend to minimize or deny their disorder. Copyright © 2013 Elsevier Inc. All rights reserved.
Stewart, Catherine S; McEwen, Fiona S; Konstantellou, Anna; Eisler, Ivan; Simic, Mima
Evidence links high levels of Autism Spectrum Disorder Traits in women with chronicity of anorexia nervosa. This study reports through clinical audit the impact of ASD traits on treatment outcomes of girls who were referred for treatment in a specialist eating disorder service. Presence of current, but not early childhood, ASD traits was elevated in comparison with previously reported community samples. Current ASD traits were correlated with emotional disorders and with need for treatment augmentation (psychiatric inpatient or day patient admission), but this relationship was not significant after the contribution of depression had been controlled for. There was no difference in Morgan Russell Outcomes at discharge for those with high and low current ASD traits. Parent-reported ASD-related developmental difficulties were associated with attenuated change in self-reported cognitive symptoms of AN. This study highlights the need for further understanding of the aetiology, diagnostic significance and predictive utility for future relapse of elevated ASD traits in childhood eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
McEvoy, Peter M; Burgess, Melissa M; Page, Andrew C; Nathan, Paula; Fursland, Anthea
Integrative models of psychopathology suggest that quality of interpersonal relationships is a key determinant of psychological well-being. However, there is a relative paucity of research evaluating the association between interpersonal problems and psychopathology within cognitive behavioural therapy. Partly, this may be due to lack of brief, well-validated, and easily interpretable measures of interpersonal problems that can be used within clinical settings. The aim of the present study was to evaluate the psychometric properties, factor invariance, and external validity of the Inventory of Interpersonal Problems 32 (IIP-32) across anxiety, depression, and eating disorders. Two treatment-seeking samples with principal anxiety and depressive disorders (AD sample, n = 504) and eating disorders (ED sample, n = 339) completed the IIP-32 along with measures of anxiety, depression, and eating disorder symptoms, as well as quality of life (QoL). The previously established eight-factor structure of the IIP-32 provided the best fit for both the AD and ED groups, and was robustly invariant across the two samples. The IIP-32 also demonstrated excellent external validity against well-validated measures of anxiety, depression, and eating disorder symptoms, as well as QoL. The IIP-32 provides a clinically useful measure of interpersonal problems across emotional and ED. © Commonwealth of Australia 2012.
Kosmerly, Stacey; Waller, Glenn; Lafrance Robinson, Adele
Clinicians have been shown to drift away from protocol in their delivery of evidence-based treatments. This study explores this phenomenon in the delivery of family-based therapy (FBT) for eating disorders, and the clinician characteristics that might explain such therapist drift. The participants were 117 clinicians who reported using FBT for eating disorders. They completed an online survey, which included questions relating to clinician characteristics, caseload, and reported use of FBT manuals and core therapeutic tasks, as well as a measure of anxiety. The use of core FBT tasks was higher than for other therapies, but there were still noteworthy gaps between recommended and reported practice. Approximately a third of clinicians reported delivering "FBT" that deviated very substantially from evidence-based protocols, often appearing to be on an individual therapy basis. Using an FBT manual to guide treatment delivery was associated with greater adherence to recommended techniques. Clinician caseload and anxiety were associated with differences in the use of specific FBT tasks. Consistent with previous research regarding clinicians' use of other therapies, the delivery of FBT for the eating disorders is not homogeneous. Further investigation of this phenomenon is needed to determine the impact of deviating from treatment protocols on the effectiveness of FBT for the eating disorders. © 2014 Wiley Periodicals, Inc.
Berkman, Nancy D; Bulik, Cynthia M; Brownley, Kimberly A; Lohr, Kathleen N; Sedway, Jan A; Rooks, Adrienne; Gartlehner, Gerald
OBJECTIVES The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed evidence on efficacy of treatment for anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), harms associated with treatments, factors associated with the treatment efficacy and with outcomes of these conditions, and whether treatment and outcomes for these conditions differ by sociodemographic characteristics. DATA SOURCES We searched MEDLINE, the Cumulative Index to Nursing and Applied Health (CINAHL), PSYCHINFO, the Educational Resources Information Center (ERIC), the National Agricultural Library (AGRICOLA), and Cochrane Collaboration libraries. REVIEW METHODS We reviewed each study against a priori inclusion/exclusion criteria. For included articles, a primary reviewer abstracted data directly into evidence tables; a second senior reviewer confirmed accuracy. We included studies published from 1980 to September 2005, in all languages. Studies had to involve populations diagnosed primarily with AN, BN, or BED and report on eating, psychiatric or psychological, or biomarker outcomes. RESULTS We report on 30 treatment studies for AN, 47 for BN, 25 for BED, and 34 outcome studies for AN, 13 for BN, 7 addressing both AN and BN, and 3 for BED. The AN literature on medications was sparse and inconclusive. Some forms of family therapy are efficacious in treating adolescents. Cognitive behavioral therapy (CBT) may reduce relapse risk for adults after weight restoration. For BN, fluoxetine (60 mg/day) reduces core bulimic symptoms (binge eating and purging) and associated psychological features in the short term. Individual or group CBT decreases core behavioral symptoms and psychological features in both the short and long term. How best to treat individuals who do not respond to CBT or fluoxetine remains unknown. In BED, individual or group CBT reduces binge eating and improves abstinence rates for up
Fitzsimmons-Craft, Ellen E; Eichen, Dawn M; Kass, Andrea E; Trockel, Mickey; Crosby, Ross D; Taylor, C Barr; Wilfley, Denise E
Understanding how known eating disorder (ED) risk factors change in relating to one another over time may inform efficient intervention targets. We examined short-term (i.e., 1 month) reciprocal longitudinal relations between weight/shape concern and comorbid symptoms (i.e., depressed mood, anxiety) and behaviors (i.e., binge drinking) over the course of 24 months using cross-lagged panel models. Participants were 185 women aged 18-25 years at very high risk for ED onset, randomized to an online ED preventive intervention or waitlist control. We also tested whether relations differed based on intervention receipt. Weight/shape concern in 1 month significantly predicted depressed mood the following month; depressed mood in 1 month also predicted weight/shape concern the following month, but the effect size was smaller. Likewise, weight/shape concern in 1 month significantly predicted anxiety the following month, but the reverse was not true. Results showed no temporal relations between weight/shape concern and binge drinking in either direction. Relations between weight/shape concern, and comorbid symptoms and behaviors did not differ based on intervention receipt. Results support focusing intervention on reducing weight/shape concern over reducing comorbid constructs for efficient short-term change. Level I, evidence obtained from a properly designed randomized controlled trial.
Results: Results indicate that for study completers, the intervention had large effects for reduction of eating-related psychopathology (d = 1.5, weight concerns (d = .7, and psychosocial impairment (d = .7. Those who completed it rated the program very acceptable. This pilot study suggests the potential efficacy of StudentBodies-Eating Disorders as a self-help intervention for subclinical eating disorders in a non-clinical setting.
Hay, Phillipa; Katsikitis, Mary
Emotive responses to foods in people with eating disorders are incompletely understood in relation to whether the extent of emotional response is due to the eating disorder or non-specific emotional states. The aims of the present study were to investigate negative and positive emotive responses to food images in adults with an eating disorder, and to compare responses to a (i) healthy and a (ii) clinic (psychiatry) control group. Participants viewed 20 images (16 of foods previously found to evoke fear, disgust and happiness and 4 neutral images) at half-minute intervals and rated emotive responses on 3 visual analogue scales for each image. Participants with an eating disorder (n=26) were found to have significantly increased negative emotive (disgust and fear) responses and reduced positive (happiness) responses to the images compared to the 20 clinic and 61 healthy participants. Differences between groups remained significant when controlling for baseline levels of fear, disgust and happiness. Thus, the emotive responses to foods did not appear due to non-specific increases in anxiety or depression but rather was due to the presence of an eating disorder. Copyright © 2014 Elsevier Ltd. All rights reserved.
Variation in reproductive outcomes of women with histories of bulimia nervosa, anorexia nervosa, or eating disorder not otherwise specified relative to the general population and closest-aged sisters.
Tabler, Jennifer; Utz, Rebecca L; Smith, Ken R; Hanson, Heidi A; Geist, Claudia
This study seeks to examine the long-term reproductive consequences of eating disorders (ED), to assess variation in reproductive outcomes by ED type, and to examine reproductive differences between women with previous ED diagnosis and their discordant sisters. Using a sample of women with previous ED diagnosis generated by the Utah Population Database, this study compares the fecundity (parity) and age at first birth of women by ED subtype (bulimia nervosa [BN], anorexia nervosa [AN], and ED not otherwise specified [EDNOS]) (n = 1,579). We also employed general population match case-control, and discordant sibling pair analyses, to estimate the magnitude of association between EDs and reproductive outcomes. Women previously diagnosed with AN or EDNOS experienced delayed first birth (HRR = 0.33, HRR = 0.34, respectively) and lower parity (IRR = 0.19, IRR = 0.22, respectively) relative to BN (p EDNOS diagnosis. Women previously diagnosed with AN or EDNOS likely experience the greatest reductions and delays in reproduction across their lifespan. Reproductive health screenings may be especially critical for the wellbeing of women with a history of AN or EDNOS. © 2018 Wiley Periodicals, Inc.
Keel, Pamela K; Brown, Tiffany A; Holland, Lauren A; Bodell, Lindsay P
Current diagnostic criteria for anorexia nervosa (AN) and bulimia nervosa (BN) account for a minority of individuals with clinically significant disorders of eating, raising concerns about the clinical utility of current definitions. This review examines evidence for the validity of current and alternative approaches to defining eating disorders and implications for draft criteria for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Although this review largely supports the predictive validity of distinctions among AN, BN, and the newly proposed binge eating disorder (BED), it also highlights that our tendency to "study what we define" has created a gap between the problems that people have and what we know about those problems. Future research on the causes and consequences of eating disorders should include more heterogeneous groups to enable identification of meaningful boundaries that distinguish between disorders based on etiological and predictive validity.
Suokas, Jaana; Alenius, Heidi; Ebeling, Hanna; Haapasalo-Pesu, Kirsi-Maria; Järvi, Leea; Koskinen, Minna; Laukkanen, Eila; Meskanen, Katarina; Morin-Papunen, Laure; Ryöppönen, Anita; Salonen, Ulla; Tossavainen, Päivi; Vuorela, Piia
Early diagnosis with intervention is linked to better outcome. In primary care patients in risk for eating disorder should be screened and actively asked about eating disorder symptoms. Treatment is mainly out-patient care and should first be focused on gaining a normal nutritional status. It is important to involve the patient's family in the treatment. A confidential relationship between health care professionals and the patient is important. The patient's own motivation and readiness for recuperation are essential. Different therapeutic and psychosocial approaches are central in the treatment, as the disorders are psychiatric. Medical treatment may bring additional help in treating binge-eating disorder or bulimia nervosa, but it is seldom of help in treating anorexia nervosa.
Vaz, F J; Alcaina, T; Guisado, J A
The food aversions of a group of anorexia nervosa patients, bulimia nervosa patients, and no eating disordered individuals (controls) were compared. An open questionnaire was used to obtain data on the eating aversions of each of the three populations. The foodstuffs were placed in categories according to their nutritional value. They were also converted into nutrients, and the average value for each population was calculated. With the exception of the 'legumes' and 'dry fruits' categories, the degree of aversion towards the other food groups detected in the individuals with eating disorders was significantly greater than that detected in controls. Aversion towards food with a high protein content (meat, fish, milk and eggs) was characteristic of patients with eating disorders and is a source of clinical problems, which are discussed in this article.
Full Text Available Federica Pinna, Lucia Sanna, Bernardo Carpiniello Department of Public Health, Clinical and Molecular Medicine - Unit of Psychiatry, University of Cagliari, Cagliari, Italy Abstract: A high percentage of individuals affected by eating disorders (ED achieve incomplete recovery following treatment. In an attempt to improve treatment outcome, it is crucial that predictors of outcome are identified, and personalized care approaches established in line with new treatment targets, thus facilitating patient access to evidence-based treatments. Among the psychological factors proposed as predictors of outcome in ED, alexithymia is of outstanding interest. The objective of this paper is to undertake a systematic review of the literature relating to alexithymia, specifically in terms of the implications for treatment of ED. In particular, issues concerning the role of alexithymia as a predictor of outcome and as a factor to be taken into account in the choice of treatment will be addressed. The effect of treatments on alexithymia will also be considered. A search of all relevant literature published in English using PubMed, PsycINFO, and Scopus databases was carried out on the basis of the following keywords: alexithymia, anorexia nervosa, bulimia nervosa, eating disorders, and treatment; no time limits were imposed. Despite the clinical relevance of alexithymia, the number of studies published on the above cited aspects is somewhat limited, and these studies are largely heterogeneous and feature significant methodological weaknesses. Overall, data currently available mostly correlate higher levels of alexithymia with a less favorable outcome in ED. Accordingly, alexithymia is seen as a relevant treatment target with the aim of achieving recovery of these patients. Treatments focusing on improving alexithymic traits, and specifically those targeting emotions, seem to show greater efficacy, although alexithymia levels often remain high even after specific
Beauchamp, Marshall T; Lundgren, Jennifer D
Bright light therapy is a noninvasive biological intervention for disorders with nonnormative circadian features. Eating disorders, particularly those with binge-eating and night-eating features, have documented nonnormative circadian eating and mood patterns, suggesting that bright light therapy may be an efficacious stand-alone or adjunctive intervention. The purpose of this systematic literature review, using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, was (1) to evaluate the state of the empirical treatment outcome literature on bright light therapy for eating disorders and (2) to explore the timing of eating behavior, mood, and sleep-related symptom change so as to understand potential mechanisms of bright light therapy action in the context of eating disorder treatment. A comprehensive literature search using PsycInfo and PubMed/MEDLINE was conducted in April 2016 with no date restrictions to identify studies published using bright light therapy as a treatment for eating disorders. Keywords included combinations of terms describing disordered eating (eating disorder, anorexia nervosa, bulimia nervosa, binge eating, binge, eating behavior, eating, and night eating) and the use of bright light therapy (bright light therapy, light therapy, phototherapy). After excluding duplicates, 34 articles were reviewed for inclusion. 14 published studies of bright light therapy for eating disorders met inclusion criteria (included participants with an eating disorder/disordered-eating behaviors; presented as a case study, case series, open-label clinical trial, or randomized/nonrandomized controlled trial; written in English; and published and available by the time of manuscript review). Results suggest that bright light therapy is potentially effective at improving both disordered-eating behavior and mood acutely, although the timing of symptom response and the duration of treatment effects remain unknown. Future research should
Durkin, Nora E; Swanson, Sonja A; Crow, Scott J; Mitchell, James; Peterson, Carol B; Crosby, Ross
Chewing and spitting (CS) out food is a relatively understudied eating disorder behavior. The aim of this study was to examine lifetime and current frequencies of CS across eating disorder diagnostic groups and to compare the severity of eating disorder symptomatology between participants who did and did not endorse CS. A total of 972 individuals presenting for outpatient eating disorder treatment between 1985 and 1996 completed a questionnaire that included items regarding current and lifetime eating disorder behaviors, including CS. Results indicated that both lifetime and current prevalence estimates of CS varied cross-diagnostically, with CS being more common among those with anorexia nervosa and bulimia nervosa compared to those with eating disorder not otherwise specified. CS was significantly associated with several eating disorder symptoms, including compensatory behaviors, meal restriction, and lower BMI. Those who reported CS were also younger in age compared to those who did not report CS. These findings indicate that CS is associated with more severe eating and weight pathology and is not equally prevalent across eating disorder diagnoses. These results also support the relatively high occurrence of CS and the importance of targeting this behavior in eating disorder treatment. Future research should clarify the correlates, mechanisms, and function of CS in eating disorders.
Díaz-Marsá, Marina; Alberdi-Páramo, Iñigo; Niell-Galmés, Lluis
Eating disorders (EDs) are a series of differentiated nosological entities sharing the common link of a continuous alteration in food intake or in food intake-related behavior. Within this classification, the following disorders are noteworthy: anorexia nerviosa (AN) and bulimia nerviosa (BN). Anorexia nervosa is a chronic disorder characterized mainly by negative or decreased food intake accompanied by a distortion of body image and intense accompanying fear of weight gain. The estimated vital prevalence of this disorder in adolescence is approximately 0.5%-1%.1 The primary feature of BN is the presence of binge eating accompanied by compensatory behavior (in the form of intense exercise and the use of laxatives and diuretics, etc.). The prevalence of BN is estimated to be between 2% and 4% in young women, and it generally starts at somewhat later stages than AN. It is believed that biological, psychological, and environmental factors, as well as genetic vulnerability, influence the pathogenesis of EDs. A variety of therapies exist, both biological and psychological, whose effectiveness is supported by the scientific literature. Nonetheless, we find these therapies only partially effective and new targets as well as new treatments should be sought. Although the etiopathogenesis of EDs is unclear, some of the neurobiological dysfunction found suggests that diet and nutrient supplementation could be relevant in their treatment. We review in this article new treatments focusing on nutritional deficits.
Howell, Michael J; Schenck, Carlos H
Identifying abnormal nocturnal eating is critically important for patient care and public health. Obesity is a global pandemic and a leading cause of preventable mortality in the United States, with more than 100,000 deaths annually. Normally, nighttime energy homeostasis is maintained, despite an absence of food intake, through appetite suppression and alterations in glucose metabolism that result in stable energy stores. Two conditions break this nighttime fast and are associated with weight gain as well as medical and neuropsychiatric comorbidities. Sleep-related eating disorder (SRED) is characterized by isolated nocturnal eating, whereas the night-eating syndrome (NES) is a circadian delay in meal timing leading to evening hyperphagia, nocturnal eating, and morning anorexia. Recently, SRED has been associated with the benzodiazepine receptor agonist zolpidem. Both SRED and NES are treatable and represent potentially reversible forms of obesity. In SRED, the antiseizure medication topiramate and dopaminergics have both demonstrated promising results. Nocturnal eating associated with NES has responded well to sertraline.
Wallin, Karin; Pettersen, Gunn; Björk, Tabita; Råstam, Maria
Our knowledge about males’ perceptions about causes of eating disorder is very limited, but can be useful in the treatment planning for males. The aim of this study was to describe how male former patients perceived causes of onset of their eating disorder. Fifteen males previously treated for eating disorders and now considering themselves as recovered where interviewed at ages 19 - 52. All interviews were recorded and analyzed qualitatively using a phenomenographic approach. Three catego...
Eiber, R; Mirabel-Sarron, C; Urdapilleta, I
Cognitions are of crucial importance in the -aetiology and the maintenance of eating disorders. Dysfunctional cognitions in eating disorders are related to body image, self-esteem and feeding. The aim of this paper is to review the actual knowledge in this area. First, we will display -cognitive models in eating disorders. Cognitive factors in -eating disorders are logical errors, cognitive slippage and conceptual complexity. Eating disorder patients seem to have a deficient cognitive development. Some cognitive models stipulate that eating disorder patients may develop organised cognitive structures schemas concerning the issues of weight and its implications for the self. These schemas can account for the persistence and for the understanding the "choice of the eating disorder symptomatology. Cognitive pheno-mena of interest are self-schema, weight-related schema and weight-related self-schema. The maintenance model of ano-rexia nervosa argued that, initially there is an extreme need to control eating which is supported by low self-esteem. The maintenance of the disorder is reinforced by three mechanisms: dietary restriction enhances the sense of being in control; aspects of starvation encourage further dietary restriction; concerns about shape and weight encourage restriction. The development and maintenance of bulimic symptomatology are explained by placing a high value on attaining an idealised weight and body shape accompanied by inaccurate beliefs. The cognitive model of specific family of origin experiences puts forward the development of -maladaptative expectancies for eating and thinness. Second, we discuss distortions in information processing. a) In feeding laboratories, bulimics show a wide range of caloric intake and a disruption of circadian feeding patterns. In overeating bulimics, large meals occurred mainly during afternoon and evening with high fat and carbohydrate intake, but the majority of meals were of normal size and frequency. Responsivity
King, M B
A total of 748 patients who attended four south London group practices were screened using the eating attitudes test; 1% of women had bulimia nervosa and a further 3% a partial syndrome eating disorder. Eating and weight control behaviour and psychiatric indicators for an eating disorder were analysed. Patients with bulimia nervosa and partial syndromes were remarkably similar. They were mainly women, from the middle to upper classes, in the normal weight range but having had considerable weight fluctuation in the past, more likely to have had a history of menstrual irregularity, often psychologically troubled, and tended to have more family psychopathology. PMID:3099893
Lipsky, Rachele K; McGuinness, Teena M
Children and adolescents who eat unusually large amounts of food, feel guilty about it, and try to hide their overeating may be struggling with binge eating disorder (BED), a condition associated with suicidal ideation and other eating disorders. Although BED is new to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, the syndrome is becoming increasingly recognized. The study of BED in children and adolescents is in its natal phase, but the importance of recognition and possible treatment strategies are discussed in the current article along with psychiatric nursing implications. Copyright 2015, SLACK Incorporated.
Pengpid, Supa; Peltzer, Karl; Ahsan, Gias Uddin
As there is a lack of information on eating disorders in Bangladesh, the aim of this study was to explore the eating disorder attitudes and behaviors among undergraduate university students in the country. A cross-sectional questionnaire survey and anthropometric measurement were conducted with undergraduate students who were recruited randomly from classes. The Eating Attitudes Test (EAT-26) was used to determine the prevalence of disordered eating attitudes. The sample included 800 university students (56.6% men and 43.4% women), with a mean age of 21.0 years (SD=32.5). Using the EAT-26, 37.6% of the students were classified as being at risk for an eating disorder. In multivariate analysis, being a late adolescent (17-19 years), high religious involvement, overweight body perception, low body appreciation, having had cosmetic surgery, and current binge drinking were found to be associated with an eating disorder risk. Very high rates of eating disorder risk were found. This result calls for increased awareness and understanding of eating disorders, and related risk factors and interventions in university students in Bangladesh.
Aranha, Ana Cecília Corrêa; Eduardo, Carlos de Paula; Cordás, Táki Athanassios
The aim of this article is to present a review of the literature on eating disorders and related oral implications in order to provide oral healthcare professionals and psychiatrists with information that will enable them to recognize and diagnose these disorders and render appropriate treatment. A comprehensive review of the literature was conducted with special emphasis on the oral implications of anorexia nervosa and bulimia nervosa. Currently, available knowledge that correlates eating disorders with dental implications is supported by data derived from well-conducted psychiatric and psychological literature. However, little is known about the aspects of oral medicine concerned with the subject. Dental erosion, xerostomia, enlargement of the parotid gland, and other dental implications might be present in individuals with eating disorders. Eating disorders are a serious concern with regard to the oral health of patients. They represent a clinical challenge to dental professionals because of their unique psychological, medical, nutritional, and dental patterns as well as their unique characteristics. However, there is a general lack of awareness of the fundamental importance of the dentist's role in the multidisciplinary treatment of affected patients. The failure of oral healthcare professionals to recognize dental characteristics of eating disorders may lead to serious systemic problems in addition to progressive and irreversible damage to the hard tissues. Considering the increasing incidence and prevalence rates of eating disorders the participation of oral healthcare professionals in a multidisciplinary team to provide care for affected patients rises to greater importance.
Claes, Laurence; Bijttebier, Patricia; Mitchell, James E; de Zwaan, Martina; Mueller, Astrid
The aim of the present study was to investigate the relationship between compulsive buying (CB), eating disorder symptoms, and temperament (controlling for depression) in a sample of female students. We assessed 211 female undergraduate students using the Compulsive Buying Scale, the Eating Disorder Inventory, the Behavioral Inhibition System and Behavioral Activation System scales, the Adult Temperament Questionnaire, and the Physical Health Questionnaire-Depression. The results show a positive association between CB and the Eating Disorder Inventory-II drive for thinness and bulimia subscales. Both CB and eating disorder symptoms were related to low levels of effortful control. Finally, CB was also related to high levels of Behavioral Activation Scale reactivity (impulsivity), whereas eating disorder symptoms (especially drive for thinness) were more strongly related to high levels of Behavioral Inhibition Scale reactivity (anxiety). The implications of these findings for the treatment of CB and eating disorder symptoms will be discussed. © 2011 Elsevier Inc. All rights reserved.
Full Text Available Sleep-related eating disorder (SRED is characterized by recurrent episodes of involuntary eating during sleep period and is often associated with restless legs syndrome (RLS. Although pharmacotherapy is recommended for SRED patients, no drug have shown promising effects so far. The patient, a 48-year-old Japanese housewife, first visited our clinic and complained about nighttime eating. She had a history of hypertension, diabetes mellitus, sleep apnea syndrome, and depression. Insomnia appeared 10 years before the first visit and she often received hypnosedatives; at the same time, she developed nocturnal eating episodes. She had amnesia for these episodes, and she felt urge to move her legs while sleeping. The patient was diagnosed with SRED and RLS. Reduction in the doses of triazolam decreased her nighttime eating frequency, and her complete amnesia changed to vague recall of eating during night. Clonazepam 1.0 mg at bedtime decreased nocturnal eating frequency from 1 to 2 times per month, though sleepwalking remained. Administration of pramipexole 0.125 mg relieved all symptoms including SRED, RLS, and sleepwalking. This is the first paper to report that the combination of clonazepam and pramipexole therapy-reduced SRED episodes and RLS symptoms.
Vancampfort, Davy; De Herdt, Amber; Vanderlinden, Johan; Lannoo, Matthias; Soundy, Andrew; Pieters, Guido; Adriaens, An; De Hert, Marc; Probst, Michel
This study compared the mental and physical health related quality of life (HRQL) of 40 obese persons with BED with 20 age, gender and body mass index (BMI) matched obese persons without BED and 40 age and gender matched non-obese volunteers. Variables contributing to the variability in HRQL were identified. Participants were asked to fill in the MOS 36-item Short Form Health Survey (SF-36), the Symptoms Checklist-90 (SCL-90), the Baecke questionnaire, the bulimia subscale of the Eating Disorder Inventory and the Body Attitude Test. All participants also performed a 6-minute walk test (6MWT). BED patients showed a significant impaired physical and mental HRQL compared with obese and non-obese control groups. In the BED-group female participants showed a significantly more impaired mental HRQL than male participants (40.0±21.2 versus 66.6±10.1). The distance achieved on the 6MWT (512.1±75.8m) explained 22.5% of the variability in physical HRQL in the obese BED-group while gender and the SCL-90 depression score (39.1±12.2) explained 47.1% of the variability in mental HRQL. The present findings suggest that the treatment of obese individuals with BED might benefit by giving more attention to HRQL, depressive symptoms and physical fitness. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Pratt, B M; Woolfenden, S R
/or electronic mail. Randomised controlled trials (RCT) with a major focus on eating disorder prevention programs for children and adolescents, where there is no known DSM-IV diagnosis of an eating disorder, are eligible for inclusion in the review. Trials must include a control group and at least one objective outcome measure (eg. BMI) or a standardised psychological measure used with the intervention and control group, pre- and post-intervention. A total of 1379 titles have been identified through the search to date. 13 studies were located that reported use of a randomised controlled trial methodology and were critically appraised by two independent reviewers. Five (5) studies were excluded as data were not reported in a useable form or useable data could not be obtained from the trial authors, one dissertation could not be obtained, one study had no "true" no-treatment or usual treatment control group, and one study did not use a pre-test outcome measure. Eight (8) studies met the selection criteria outlined above. Only one of eight pooled comparisons of two or more studies using similar outcome measures and similar intervention types demonstrated the statistically significant effect of a particular type of eating disorder prevention program for children and adolescents. Combined data from two eating disorder prevention programs based on a media literacy and advocacy approach indicate a reduction in the internalisation or acceptance of societal ideals relating to appearance at a 3- to 6-month follow-up (Kusel, unpublished; Neumark-Sztainer2000) [SMD -0.28, -0.51 to -0.05, 95% CI]. However, there is insufficient evidence to conclude that this approach also demonstrated a significant impact on awareness of societal standards relating to appearance. There is insufficient evidence to support the effect of four programs designed to address eating attitudes and behaviours and other adolescent issues on body weight, eating disorder symptoms, associated eating disorder
Modan-Moses, Dalit; Levy-Shraga, Yael; Pinhas-Hamiel, Orit; Kochavi, Brigitte; Enoch-Levy, Adi; Vered, Iris; Stein, Daniel
Previous studies assessing vitamin D status in adolescents with eating disorders showed inconsistent results. The aim of the current study was to assess vitamin D status in a large cohort of adolescent inpatients with eating disorders and its relation to bone mineral density (BMD) and depression. 25-Hydroxyvitamin D (25OHD), calcium, phosphorus, and alkaline phosphatase levels as well as BMD and depression were assessed on admission in 87 inpatients (aged 16 ± 2 years, females = 81) with eating disorders [anorexia nervosa (AN) = 64; bulimia nervosa (BN) = 5; eating disorders not otherwise specified-binge/purge type (EDNOS-B/P) = 18]. Mean 25OHD levels were 24.1 ± 7.5 ng/ml (25.0 ± 7.6, 25.4 ± 9.9, and 22.0 ± 9.9 ng/ml in patients with AB, BN, and EDNOS-B/P, respectively). Vitamin D deficiency (32 ng/ml, considered optimal by some experts. No associations were found between 25OHD levels and BMD or comorbid depression. 25OHD levels during winter were significantly lower than summer levels (p EDNOS-B/P type was low (-1.5 ± 1.1) and correlated with body mass index standard deviation score (p = .03). Adolescents with eating disorders show a high prevalence of vitamin D deficiency and insufficiency. Given the risk of osteoporosis in this population, 25OHD levels found in this group may not offer optimal bone protection. Vitamin D levels should be routinely checked and supplementation should be administered as required. © 2014 Wiley Periodicals, Inc.
Striegel-Moore, Ruth H.; Bulik, Cynthia M.
The authors review research on risk factors for eating disorders, restricting their focus to studies in which clear precedence of the hypothesized risk factor over onset of the disorder is established. They illustrate how studies of sociocultural risk factors and biological factors have progressed on parallel tracks and propose that major advances…
Hartmann, Armin; Zeeck, Almut; Barrett, Marna S
Eating disorders are often chronic in nature and lead to a number of problems among which interpersonal issues are suggested to be central. Although research has shown that individuals with disturbed patterns of eating consistently report problems in social interactions, this study is unique in assessing a range of interpersonal problems among patients with all types of eating disorders before and after intensive hospital-based treatment. A total of 208 patients receiving a primary diagnosis of restrictive anorexia nervosa, bulimia nervosa, or anorexia nervosa of the binge/purging-subtype were included in the study. Eating pathology, symptom severity, and interpersonal patterns were examined before and after treatment. Patients with eating disorders exhibited a generally nonassertive, submissive interpersonal style, with anorexic patients of the binge/purging-subtype reporting more difficulties with social inhibition and nonaffiliation. These patterns were found to change over the course of treatment with interpersonal problems at intake predictive of greater binge severity at discharge. Furthermore, issues of dominance and social avoidance predicted outcome for specific subgroups of patients. Results underscore the importance of interpersonal problems in eating disorders and suggest that interpersonal patterns remain a focus of treatment and future research. © 2009 by Wiley Periodicals, Inc.
Podfigurna-Stopa, Agnieszka; Czyzyk, Adam; Katulski, Krzysztof; Smolarczyk, Roman; Grymowicz, Monika; Maciejewska-Jeske, Marzena; Meczekalski, Blazej
Eating disorders (EDs) are disturbances that seriously endanger the physical health and often the lives of sufferers and affect their psychosocial functioning. EDs are usually thought of as problems afflicting teenagers. However, the incidence in older women has increased in recent decades. These cases may represent either late-onset disease or, more likely, a continuation of a lifelong disorder. The DSM-5 classification differentiates 4 categories of eating disorder: anorexia nervosa, bulimia nervosa, binge-eating disorders and other specified feeding and eating disorders. The weight loss and malnutrition resulting from EDs have widespread negative consequences for physical, mental and social health. The main risk factors for developing long-term consequences are the degree of weight loss and the chronicity of the illness. Most of the cardiac, neurological, pulmonary, gastric, haematological and dermatological complications of EDs are reversible with weight restoration. EDs are serious illnesses and they should never be neglected or treated only as a manifestation of the fashion for dieting or a woman's wish to achieve an imposed standard feminine figure. Additionally, EDs are associated with high risk of morbidity and mortality. The literature concerning EDs in older, postmenopausal women is very limited. The main aim of this paper is to ascertain the epidemiology and prognosis of EDs in older women, and to review their diagnosis and management. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Bulik, Cynthia M; Kleiman, Susan C; Yilmaz, Zeynep
We capture recent findings in the field of genetic epidemiology of eating disorders. As analytic techniques evolve for twin, population, and molecular genetic studies, new findings emerge at an accelerated pace. We present the current status of knowledge regarding the role of genetic and environmental factors that influence risk for eating disorders. We focus on novel findings from twin studies, population studies using genetically informative designs, and molecular genetic studies. Over the past 2 years, research in this area has yielded insights into: comorbidity with other psychiatric and medical disorders and with metabolic traits; developmental factors associated with the emergence of eating disorders; and the molecular genetics of anorexia nervosa. Insights from genetic epidemiology provide an important explanatory model for patients with eating disorders, family members, and clinicians. Understanding core biological determinants that explain the severity and persistence of the illnesses, their frequent co-occurrence with other conditions, and their familial patterns raises awareness and increases compassion for individuals living with these disorders. Large-scale genomic studies are currently underway. Ultimately, this domain of research may pave the way to greater understanding of the underlying neurobiology and inform the development of novel and effective interventions.
Fakra, Eric; Belzeaux, R; Azorin, J M; Adida, M
Epidemiologic studies show a frequent co-occurence of affective and eating disorders. The incidence of one disorder in patients suffering from the other disorder is well over the incidence in the general population. Several causes could explain this increased comorbidity. First, the iatrogenic origin is detailed. Indeed, psychotropic drugs, and particularly mood stabilizers, often lead to modification in eating behaviors, generally inducing weight gain. These drugs can increase desire for food, reduce baseline metabolism or decrease motor activity. Also, affective and eating disorders share several characteristics in semiology. These similarities can not only obscure the differential diagnosis but may also attest of conjoint pathophysiological bases in the two conditions. However, genetic and biological findings so far are too sparse to corroborate this last hypothesis. Nonetheless, it is noteworthy that comorbidity of affective and eating disorders worsens patients'prognosis and is associated with more severe forms of affective disorders characterized by an earlier age of onset in the disease, higher number of mood episodes and a higher suicidality. Lastly, psychotropic drugs used in affective disorders (lithium, antiepileptic mood stabilizers, atypical antipsychotics, antidepressants) are reviewed in order to weigh their efficacy in eating disorders. This could help establish the best therapeutic option when confronted to comorbidity. Copyright © 2014 L’Encéphale. Published by Elsevier Masson SAS.. All rights reserved.
Muuss, Rolf E.
Examines anorexia nervosa, an eating disorder seen with increasing frequency, especially among adolescent girls. Presents five theories about causation, discusses early characteristics, typical family patterns, physical and medical characteristics, social adjustment problems, and society's contribution to anorexia. Describes course of the…
Becker, Carolyn Black; Bull, Stephanie; Schaumberg, Katherine; Cauble, Adele; Franco, Amanda
The aim of this study was to replicate and extend results of a previous trial that investigated the effectiveness of 2 peer-led eating disorders prevention interventions in reducing eating disorder risk factors in undergraduate women (C. B. Becker, L. M. Smith, & A. C. Ciao, 2006). To extend findings from the previous study by allowing for…
Schuck, Kathrin; Munsch, Simone; Schneider, Silvia
Biased processing of body-related information may be linked to the development and maintenance of eating disorders (ED). The objective of this systematic review will be to examine the occurrence and the extent of cognitive biases in response to visual body-related stimuli in individuals with ED and individuals with an increased risk to develop ED. Studies will be identified by searching MEDLINE and PsycINFO. We will include observational and experimental studies that examine the association between cognitive biases (information processing biases) in response to visual body-related stimuli and eating-related pathology in clinical and non-clinical adult samples. In addition to database searches, citation tracking will be used. Two reviewers will first screen titles and abstracts independently and will then review full texts for eligibility. Data extraction will be done independently by two reviewers. Conflicts at all levels of screening and extraction will be resolved through discussion. Studies will be included if they 1) assess cognitive biases (i.e., attentional biases, memory biases, judgment biases, response biases, and interpretation biases) in response to visual body-related stimuli (i.e., pictures or photographs of a human body or a human body shape), 2) if they report associations between biases and eating-related pathology, 3) if study participants are at least 16 years or older, and 4) if no priming task was administered prior to the assessment. Descriptive data of studies will also be collected. Risk of bias assessment will be undertaken by two independent reviewers. Data will be analyzed using random-effects meta-analysis. This systematic review will synthesize the evidence for cognitive bias in response to visual body-related stimuli in individuals with ED and individuals with an increased risk of developing an ED. The findings may help to better understand information processing in eating-related psychopathology. PROSPERO CRD42015019165.
Elran-Barak, Roni; Fitzsimmons-Craft, Ellen E; Benyamini, Yael; Crow, Scott J; Peterson, Carol B; Hill, Laura L; Crosby, Ross D; Mitchell, James E; Le Grange, Daniel
We examined eating disorders in midlife and beyond by comparing frequency of anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified feeding or eating disorder (OSFED) among midlife eating disorder treatment-seeking individuals and younger controls. We also compared demographic and eating disorder-related characteristics across diagnoses and age groups. Participants included 2,118 treatment-seeking adults who self-reported their eating-related symptoms on the Eating Disorder Questionnaire. Results showed that percent of patients with BN was significantly lower whereas percent of patients with BED and OSFED was significantly higher among midlife relative to younger patients. Percent of patients with AN did not differ between midlife and younger patients. Additionally, midlife and younger patients with BED and OSFED differed on several demographic (e.g., marital status) and eating disorder-related characteristics (e.g., BMI, compulsive exercising). This study suggests that BN is less common whereas BED and OSFED are more common among midlife eating disorder treatment-seeking individuals relative to younger controls. In addition, AN and BN present fairly similarly whereas BED and OSFED present fairly differently among midlife patients relative to younger controls. Attention to these differences and similarities is necessary to understand eating disorders in midlife.
Hulley, A J; Hill, A J
To examine the presence of eating disorder syndromes in elite women distance runners in the United Kingdom and any associated differences in training, dieting, general health, and well-being. Athletes were selected from the top of their respective ranking lists for all middle and long-distance races in 1996/1997. All running disciplines were included (track, road, cross-country, and fell/mountain running). Athletes were sent the Eating Disorders Examination Questionnaire and a questionnaire on demographics, athletic training, diet, and health. Of the 226 athletes identified, 181 (81%) completed and returned the questionnaires. Twenty-nine athletes (16%) had an eating disorder at the time of the study (7 had anorexia nervosa [AN], 2 had bulimia nervosa [BN], and 20 had eating disorders not otherwise specified [EDNOS]) and a further 6 had received previous treatment. Comparing the eating disorder group with the rest of the sample showed no difference in age, height, preferred race distance, or the number of hours/week spent training. However, they had a significantly lower body mass index (BMI), lower self-esteem, and poorer mental health. Current and past dieting were significantly more common in the eating disorder group. The levels of AN and EDNOS are higher than would be expected in similarly aged, nonathletic women. The demands for leanness rather than exercise intensity appear to be the main risk in these elite runners. The early detection and prevention of eating disorders in women athletes should have high priority. Copyright 2001 by John Wiley & Sons, Inc.
Bello, Nicholas T; Yeomans, Bryn L
Eating disorders represent a set of psychiatric illnesses with lifelong complications and high relapse rates. Individuals with eating disorders are often stigmatized and clinicians have a limited set of treatments options. Pharmacotherapy has the potential to improve long term compliance and patient commitment to treatment for eating disorders. Areas covered: This review will examine the efficacy and safety profile of the FDA-approved medications for the treatment of bulimia nervosa (BN) and binge eating disorder (BED). This will include the evaluation of fluoxetine for BN, and lisdexamfetamine for BED. Safety information will be review from randomized control trials (RCT), open label trials, and case reports. Expert opinion: Fluoxetine for BN and lisdexamfetamine for BED are relatively safe and well-tolerated. Despite these properties, these two medications represent a limited arsenal for the pharmacological treatment of eating disorders. Thus, more research-based strategies are needed to develop safe, effective, and more targeted therapies for eating disorders.
Phillips, Katharine A; Kaye, Walter H
Body dysmorphic disorder (BDD) and eating disorders are body image disorders that have long been hypothesized to be related to obsessive-compulsive disorder (OCD). Available data suggest that BDD and eating disorders are often comorbid with OCD. Data from a variety of domains suggest that both BDD and eating disorders have many similarities with OCD and seem related to OCD. However, these disorders also differ from OCD in some ways. Additional research is needed on the relationship of BDD and eating disorders to OCD, including studies that directly compare them to OCD in a variety of domains, including phenomenology, family history, neurobiology, and etiology.
Full Text Available OBJECTIVES: The aim of this study was to explore cognitive flexibility in a large dataset of people with Eating Disorders and Healthy Controls (HC and to see how patient characteristics (body mass index [BMI] and length of illness are related to this thinking style. METHODS: A dataset was constructed from our previous studies using a conceptual shift test--the Brixton Spatial Anticipation Test. 601 participants were included, 215 patients with Anorexia Nervosa (AN (96 inpatients; 119 outpatients, 69 patients with Bulimia Nervosa (BN, 29 Eating Disorder Not Otherwise Specified (EDNOS, 72 in long-term recovery from AN (Rec AN and a comparison group of 216 HC. RESULTS: The AN and EDNOS groups had significantly more errors than the other groups on the Brixton Test. In comparison to the HC group, the effect size decrement was large for AN patients receiving inpatient treatment and moderate for AN outpatients. CONCLUSIONS: These findings confirm that patients with AN have poor cognitive flexibility. Severity of illness measured by length of illness does not fully explain the lack of flexibility and supports the trait nature of inflexibility in people with AN.
Tchanturia, Kate; Harrison, Amy; Davies, Helen; Roberts, Marion; Oldershaw, Anna; Nakazato, Michiko; Stahl, Daniel; Morris, Robin
Objectives The aim of this study was to explore cognitive flexibility in a large dataset of people with Eating Disorders and Healthy Controls (HC) and to see how patient characteristics (body mass index [BMI] and length of illness) are related to this thinking style. Methods A dataset was constructed from our previous studies using a conceptual shift test - the Brixton Spatial Anticipation Test. 601 participants were included, 215 patients with Anorexia Nervosa (AN) (96 inpatients; 119 outpatients), 69 patients with Bulimia Nervosa (BN), 29 Eating Disorder Not Otherwise Specified (EDNOS), 72 in long-term recovery from AN (Rec AN) and a comparison group of 216 HC. Results The AN and EDNOS groups had significantly more errors than the other groups on the Brixton Test. In comparison to the HC group, the effect size decrement was large for AN patients receiving inpatient treatment and moderate for AN outpatients. Conclusions These findings confirm that patients with AN have poor cognitive flexibility. Severity of illness measured by length of illness does not fully explain the lack of flexibility and supports the trait nature of inflexibility in people with AN. PMID:21698277
Belloch, Amparo; Roncero, María; Perpiñá, Conxa
Unwanted intrusive cognitions constitute the normal variant of clinically significant intrusive cognitions found in disorders such as obsessive-compulsive disorder (OCD) and eating disorders (EDs). This study investigates whether individuals who are vulnerable to OCD or EDs experience more intrusions than people with no vulnerability to these disorders, and it examines the consequences of obsessional (OITs) and eating disorder (EDITs) intrusions in the same individuals, taking into account their susceptibility to OCD, EDs or neither of the two. From a sample of 922 participants, three groups were formed: risk of OCD (n = 92), risk of EDs (n = 41) and a no-risk group (n = 100). EDITs were more frequent than OITs in the two risk groups. Within-group comparisons showed that in the OCD-risk group, the OIT had more negative consequences (interference, emotional distress, dysfunctional appraisals and neutralizing strategies) than the EDIT, whereas in the ED-risk group, the OIT and the EDIT instigated similar negative consequences. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
Schmidt, Ricarda; Tetzlaff, Anne; Hilbert, Anja
A sizeable body of research has documented Expressed Emotion (EE) to predict clinical outcomes in various psychiatric disorders, including eating disorders. Patients' perceptions of relative's EE, however, were found to play an important role in the processing of EE. This study aimed to examine the level of perceived EE in adolescent binge-eating disorder (BED) and its impact on eating disorder psychopathology. Adolescents (12-20 years) seeking treatment for BED (n = 40) were compared to adolescents without current or lifetime eating disorder (CG; n = 40). Both groups were stratified according to age, sex, body mass index (BMI, kg/m(2)), and socio-economic status. The Five Minute Speech Sample (FMSS) and the Brief Dyadic Scale of EE were administered to assess patients' perceived maternal EE. Additionally, adolescents and mothers completed questionnaires on eating disorder and general psychopathology. On the FMSS, 37.5 % of patients with BED perceived their mothers as high EE (vs. 12.5 % in the CG). On the Brief Dyadic Scale of EE, patients with BED reported significantly higher levels of perceived maternal criticism, emotional overinvolvement, and lower levels of perceived warmth than controls. After controlling for the diagnosis of BED, perceived criticism and warmth, as assessed by questionnaire, significantly explained adolescents' global eating disorder psychopathology. Negative perceptions of maternal behavior and emotional atmosphere towards the child are characteristic of adolescent BED. As documented for other eating disorders, family factors are likely to have substantial implications for the maintenance and treatment of adolescent BED.
Calvert, Fiona; Smith, Evelyn; Brockman, Rob; Simpson, Susan
The treatment of eating disorders is a difficult endeavor, with only a relatively small proportion of clients responding to and completing standard cognitive behavioural therapy (CBT). Given the prevalence of co-morbidity and complex personality traits in this population, Schema Therapy has been identified as a potentially viable treatment option. A case series of Group Schema Therapy for Eating Disorders (ST-E-g) yielded positive findings and the study protocol outlined in this article aims to extend upon these preliminary findings to evaluate group Schema Therapy for eating disorders in a larger sample ( n = 40). Participants undergo a two-hour assessment where they complete a number of standard questionnaires and their diagnostic status is ascertained using the Eating Disorder Examination. Participants then commence treatment, which consists of 25 weekly group sessions lasting for 1.5 h and four individual sessions. Each group consists of five to eight participants and is facilitated by two therapists, at least one of who is a registered psychologist trained on schema therapy. The primary outcome in this study is eating disorder symptom severity. Secondary outcomes include: cognitive schemas, self-objectification, general quality of life, self-compassion, schema mode presentations, and Personality Disorder features. Participants complete psychological measures and questionnaires at pre, post, six-month and 1-year follow-up. This study will expand upon preliminary research into the efficacy of group Schema Therapy for individuals with eating disorders. If group Schema Therapy is shown to reduce eating disorder symptoms, it will hold considerable promise as an intervention option for a group of disorders that is typically difficult to treat. ACTRN12615001323516. Registered: 2/12/2015 (retrospectively registered, still recruiting).
Bardone-Cone, Anna M.; Higgins, M. K.; St George, Sara M.; Rosenzweig, Ilyssa; Schaefer, Lauren M.; Fitzsimmons-Craft, Ellen E.; Henning, Taylor M.; Preston, Brittany F.
This study examined the relationship between behavioral and psychological aspects of exercise and eating disorder recovery. Participants were categorized as having an eating disorder (n = 53), partially recovered (n = 15), fully recovered (n = 20), or non-eating disorder controls (n = 67). Groups did not differ significantly in time spent exercising, but did differ in exercise intensity, guilt related exercise, obsessive exercise cognitions, and appearance/weight management and stress/mood management motivations for exercise. Results support the importance of measuring psychological aspects of exercise in particular across the course of an eating disorder. PMID:27463591
Lock, James; La Via, Maria C
This Practice Parameter reviews evidence-based practices for the evaluation and treatment of eating disorders in children and adolescents. Where empirical support is limited, clinical consensus opinion is used to supplement systematic data review. The Parameter focuses on the phenomenology of eating disorders, comorbidity of eating disorders with other psychiatric and medical disorders, and treatment in children and adolescents. Because the database related to eating disorders in younger patients is limited, relevant literature drawn from adult studies is included in the discussion. Copyright © 2015 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Dakanalis, Antonios; Zanetti, Assunta M; Riva, Giuseppe; Colmegna, Fabrizia; Volpato, Chiara; Madeddu, Fabio; Clerici, Massimo
Body dissatisfaction is recognized as a robust risk factor for eating disorders. Despite over 80% of college men being body dissatisfied, not all men report several levels of eating disorder symptoms. In this study, we examined poor impulse control, social anxiety and internalization of media ideals as potential moderators. Data collected from 405 college-aged men were analysed, using latent variable structural equation modelling approach. All variables investigated have been found to moderate the body dissatisfaction-eating disorder symptomatology, such that male body dissatisfaction was strongly related to men's eating disorder symptomatology when each moderator was at its highest level. Practical implications are discussed. © The Author(s) 2013.
Full Text Available Eating disorders, including anorexia and bulimia nervosa, are potentially life-threatening syndromes characterized by severe disturbances in eating behavior. An effective treatment strategy for these conditions remains to be established, as patients with eating disorders tend to suffer from multiple relapses. Because ghrelin was originally discovered in the stomach mucosa, it has been widely studied over the past decade in an effort to uncover its potential roles; these studies have shed light on the mechanism by which ghrelin regulates food intake. Thus, studying ghrelin in the context of eating disorders could improve our understanding of the pathogenesis of eating disorders, possibly resulting in a promising new pharmacological treatment strategy for these patients. In addition, early detection and treatment of eating disorders are critical for ensuring recovery of young patients. Oral symptoms, including mucosal, dental, and saliva abnormalities, are typically observed in the early stages of eating disorders. Although oral care is not directly related to the treatment of eating disorders, knowledge of the oral manifestations of eating disorder patients may aid in early detection, resulting in earlier treatment; thus, oral care might contribute to overall patient management and prognosis. Moreover, ghrelin has also been found in saliva, which may be responsible for oral hygiene and digestion-related functions. This review discusses the pharmacological potential of ghrelin in regulating food-intake and the role of saliva and oral care in young patients with eating disorders.
Onnis, L; Barbara, E; Bernardini, M; Caggese, A; Di Giacomo, S; Giambartolomei, A; Leonelli, A; Mule', A M; Nicoletti, P G; Vietri, A
This article presents the results of a broader clinical research into the effectiveness of integrated treatments in teenage eating disorders, carried out at the Complex Operative Unit of Psychotherapy (Unità Operativa Complessa or U.O.C.) of the Department of Psychiatric Sciences and Psychological Medicine in collaboration with the Department of Neuropsychiatric Science for Child Development (Dipartimento di Scienze Neuropsichiatriche dell'Età Evolutiva), both at the "La Sapienza" University of Rome. The hypothesis of this research project is that in diagnosticable situations such as anorexia or bulimia, an integrated and multidisciplinary treatment, which combines medical-nutritional interventions and family psychotherapy, allows better results than a single kind of treatment, which is the usual medical- nutritional intervention supported by psychiatric counselling. Twenty-eight cases (16 of bulimia and 12 of anorexia) were selected and then subdivided, with a randomized distribution, into two (experimental and control) homogeneous groups of 14 patients. The grouping variables were the diagnosis, the disorder's seriousness and duration, BMI, gender, age, family composition and social status. The variables which have been examined in this article are the clinical parameters, which were valuated in accordance with the DSM IV-TR criteria, and relational parameters which were explored through the use of the W.F.T. Test (Wiltwyck Family Tasks). These parameters were tested at beginning as well as at the end of the therapies, in both the experimental group and the control group. Statistical analysis has shown that the experimental group, which was followed with the integrated treatment, experienced a significant improvement of the parameters as related to dysfunctional family interaction modalities, and that this improvement was correlated to the positive evolution of the clinical parameters. This improvement was not present or not of the same degree in the control
Full Text Available Objective. Eating disorders commonly present with nonspecific findings, masquerading as other, more common etiologies of malnutrition and wasting. In low-prevalence populations, these ambiguities can complicate clinicians’ diagnostic reasoning, resulting in delayed or missed diagnoses. Method. We report the atypical case of a 51-year-old male with a five-year history of unexplained weight loss despite extensive past medical evaluation. Previous documentation of profound lymphopenia and bone marrow atrophy had not been linked to a known association with eating disorders. Results. Evaluation for medical etiologies of wasting was negative. Following psychiatric evaluation, the patient was diagnosed with an eating disorder, not otherwise specified, and admitted to a specialized nutritional rehabilitation program. Conclusion. The nonspecific clinical history, physical exam, and laboratory abnormalities of eating disorders can make these diagnoses challenging and delay appropriate treatment. Clinicians should consider eating disorders in patients with malnutrition, severe lymphopenias, and gelatinous marrow transformation early in their workup, so as to avoid potentially negative outcomes.
Becker, Carolyn Black; Smith, Lisa M.; Ciao, Anna C.
The authors investigated the effectiveness of 2 interventions in reducing eating disorder risk factors under naturalistic conditions in sororities. On the basis of previous research, the campus sororities chose to implement a semimandatory, 2-session eating disorder prevention program to all new sorority members (N = 90) during sorority…
Donaldson, Abigail A; Gordon, Catherine M
Anorexia nervosa (AN) is a psychiatric illness with profound medical consequences. Among the many adverse physical sequelae of AN, bone health is impacted by starvation and can be permanently impaired over the course of the illness. In this review of skeletal complications associated with eating disorders, we discuss the epidemiology, neuroendocrine changes, adolescent vs. adult skeletal considerations, orthopedic concerns, assessment of bone health, and treatment options for individuals with AN. The focus of the review is the skeletal sequelae associated with anorexia nervosa, but we also briefly consider other eating disorders that may afflict adolescents and young adults. The review presents updates to the field of bone health in AN, and also suggests knowledge gaps and areas for future investigation. Copyright © 2015 Elsevier Inc. All rights reserved.
Byrne, Meghan E; Eichen, Dawn M; Fitzsimmons-Craft, Ellen E; Taylor, C Barr; Wilfley, Denise E
Individuals with eating disorders (EDs) demonstrate impaired quality of life; however, less than one-third report severe clinical impairment. Thus, it is important to determine factors that may identify those who are most likely to report marked impairment. Perfectionism, emotion dysregulation, and aspects of affective disturbance, such as anxiety and depression, are independently associated with eating pathology and clinical impairment in eating and other disorders. However, little research has explored these three factors concurrently in relation to eating pathology. It is possible that the combined interaction effect of these constructs could be especially harmful. The current study examined the influence of these constructs and their interactions on clinical impairment in college-aged women at high risk for or with a DSM-5 clinical or subclinical ED. Although the three-way interaction of perfectionism, emotion dysregulation, and affective disturbance (i.e., anxiety or depression) was not significant, the two-way interaction between perfectionism and emotion dysregulation was significant such that those who were high in both perfectionism and emotion dysregulation reported the highest levels of clinical impairment. This suggests that the combination of perfectionism and emotion dysregulation may be especially problematic for those with or at high risk for EDs. Interestingly, perfectionism alone was not a predictor of clinical impairment when accounting for the other constructs, implying that perfectionism may have a greater impact when in conjunction with emotion dysregulation. Understanding the impact of combined perfectionistic tendencies and emotion dysregulation on clinical impairment may better inform treatment and more directly target contributors to impaired quality of life. Copyright Â© 2016 Elsevier Ltd. All rights reserved.
Keski-Rahkonen, Anna; Mustelin, Linda
Eating disorders - anorexia nervosa, bulimia nervosa, and binge eating disorder - affect numerous Europeans. This narrative review summarizes European studies on their prevalence, incidence, comorbidity, course, consequences, and risk factors published in 2015 and the first half of 2016. Anorexia nervosa is reported by eating disorder eating disorders by 2-3% of women in Europe. Of men, 0.3-0.7% report eating disorders. Incidences of anorexia appear stable, whereas bulimia may be declining. Although the numbers of individuals receiving treatment have increased, only about one-third is detected by healthcare. Over 70% of individuals with eating disorders report comorbid disorders: anxiety disorders (>50%), mood disorders (>40%), self-harm (>20%), and substance use (>10%) are common. The long-term course of anorexia nervosa is favorable for most, but a substantial minority of eating disorder patients experience longstanding symptoms and somatic problems. The risk of suicide is elevated. Parental psychiatric disorders, prenatal maternal stress, various family factors, childhood overweight, and body dissatisfaction in adolescence increase the risk of eating disorders. Eating disorders are relatively common disorders that are often overlooked, although they are associated with high comorbidity and serious health consequences.
Davidsen, Annika Helgadóttir; Hoyt, William T; Poulsen, Stig; Waaddegaard, Mette; Lau, Marianne
The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. The study included 159 patients diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Duration of illness significantly moderated the relationship between eating disorder severity and functional impairment; the relationship was strongest for patients with a shorter duration of illness. Psychological distress partly mediated the relationship between eating disorder severity and functional impairment. Duration of illness significantly moderated the relationship between psychological distress and functional impairment; the strongest relationship was seen for patients with a shorter duration of illness. Body mass index was not a significant moderator of the relationship between ED severity and functional impairment. Overall, this study established a link between ED severity, psychological distress and functional impairment indicating that both eating disorder severity and psychological distress are more strongly related to impaired role functioning for patients with more recent onset of an eating disorder. More research in the complex relationship between ED severity and functional impairment is needed.
Nyman-Carlsson, Erika; Engström, Ingemar; Norring, Claes; Nevonen, Lauri
The Eating Disorder Inventory-3 (EDI-3) is designed to assess eating disorder psychopathology and the associated psychological symptoms. The instrument has been revised and has not yet been validated for Swedish conditions in its current form. The aim of this study was to investigate the validity and reliability of this inventory and present national norms for Swedish females. Data from patients with eating disorders (n = 292), psychiatric outpatients (n = 140) and normal controls (n = 648), all females, were used to study the internal consistency, the discriminative ability, and the sensitivity and specificity of the inventory using preliminary cut-offs for each subscale and diagnosis separately. Swedish norms were compared with those from Denmark, USA, Canada, Europe and Australian samples. The reliability was acceptable for all subscales except Asceticism among normal controls. Analysis of variance showed that the EDI-3 discriminates significantly between eating disorders and normal controls. Anorexia nervosa was significantly discriminated from bulimia nervosa and eating disorder not otherwise specified on the Eating Disorder Risk Scales. Swedish patients scored significantly lower than patients from other countries on the majority of the subscales. Drive for Thinness is the second best predictor for an eating disorder. The best predictor for anorexia nervosa was Interoceptive Deficits and Bulimia for the other diagnoses. Conclusions/clinical implications: The EDI-3 is valid for use with Swedish patients as a clinical assessment tool for the treatment planning and evaluation of patients with eating-related problems. However, it still exist some uncertainty regarding its use as a screening tool.
Jáuregui-Garrido, Beatriz; Jáuregui-Lobera, Ignacio
Beatriz Jáuregui-Garrido1, Ignacio Jáuregui-Lobera2,31Department of Cardiology, University Hospital Virgen del Rocío, 2Behavioral Sciences Institute, 3Pablo de Olavide University, Seville, SpainAbstract: Eating disorders are usually associated with an increased risk of premature death with a wide range of rates and causes of mortality. “Sudden death” has been defined as the abrupt and unexpected occurrence of fatality for which no satisfact...
The eating disorders anorexia nervosa and bulimia nervosa traditionally have been viewed as sociocultural in origin. However, recent behavioral genetic findings suggest substantial genetic influence on these disorders. Molecular genetic research of these disorders is in its infancy, but initial results are promising. This article reviews findings from family, twin, and molecular genetic studies that support substantial genetic influences on disordered eating and highlights additional areas fo...
This study provides the result of a doctorate research into the impact of existential psychotherapeutic interventions with people experiencing chronic eating disorders. The results indicate that positive outcomes are correlated to therapeutic interventions which concentrate on the clients own perception of control and choice over their own eating habits. The research aim was to explore both the effects and the effectiveness of existential therapy in altering the individuals subjective int...
Amitabh Saha; Neha Sharma
This is a case of Eating Disorder, which is described in a teenage girl who presented with intractable vomiting, hydropneumothorax and pulmonary Koch′s. The patient′s initial presentation was markedpreoccupation with body shape and image, restrictive eating, which progressed to episodes of vomiting after every meal, and led to academic decline followed by amenorrhoea and deterioration of general medical condition. She was managed with nutritional restoration, ATT and Olanzapine with Fluoxetin...
Full Text Available This is a case of Eating Disorder, which is described in a teenage girl who presented with intractable vomiting, hydropneumothorax and pulmonary Koch′s. The patient′s initial presentation was markedpreoccupation with body shape and image, restrictive eating, which progressed to episodes of vomiting after every meal, and led to academic decline followed by amenorrhoea and deterioration of general medical condition. She was managed with nutritional restoration, ATT and Olanzapine with Fluoxetine, to which she responded poorly.
The research aims to establish the main characteristics of subjects prone to compulsive overeating (experimental group, EG), and the differences between them and the girls who are not prone to any kind of eating disorders (control group, CG). The results of the research are in accordance with the expectations. Girls from the EG exhibit personality characteristics which are signifficantly different from the girls in the CG. These characteristics may be either possible predispositions for devel...
Abraham, Suzanne; Kellow, John
Functional gastrointestinal-like disorders (FGIDs) are prevalent among eating disorder (ED) patients. The aims are to explore the relationship between quality of life related to eating disorders (QOL ED) and FGIDs. Consecutive ED patients, 18-45 years old, completed the Rome II, QOL ED, Irritable Bowel Syndrome QOL (IBS-QOL) and Bowel Symptom Severity Index (BSSI) questionnaires on admission to hospital for treatment of their ED. Despite the high prevalence of FGIDs (93%), only IBS is clearly correlated with QOL ED scores. The QOL ED subscores significantly related are ED feelings, psychological feelings and effect on daily living. These subscores contain items such as fearing loss of control over your body and feelings, being preoccupied with thoughts of body weight and shape, feeling confused and that eating and exercise have a negative effect on work/study. There were no relationships between QOL ED behavior and individual FGIDs or categories of FGIDs. The QOL ED and IBS-QOL are highly correlated, and there is a positive linear relationship between the QOL ED global and IBS-QOL total and BSSI scores. The presence of IBS (but not other FGIDs) in ED patients is strongly related to eating disordered and psychological feelings. The poorer the QOL ED is, the poorer the IBS-QOL is and the more severe the IBS symptoms are. Crown Copyright © 2011. Published by Elsevier Inc. All rights reserved.
It is the position of the American Dietetic Association that nutrition intervention, including nutritional counseling, by a registered dietitian (RD) is an essential component of the team treatment of patients with anorexia nervosa, bulimia nervosa, and other eating disorders during assessment and treatment across the continuum of care. Diagnostic criteria for eating disorders provide important guidelines for identification and treatment. However, it is thought that a continuum of disordered eating may exist that ranges from persistent dieting to subthreshold conditions and then to defined eating disorders, which include anorexia nervosa, bulimia nervosa, and binge eating disorder. Understanding the complexities of eating disorders, such as influencing factors, comorbid illness, medical and psychological complications, and boundary issues, is critical in the effective treatment of eating disorders. The nature of eating disorders requires a collaborative approach by an interdisciplinary team of psychological, nutritional, and medical specialists. The RD is an integral member of the treatment team and is uniquely qualified to provide medical nutrition therapy for the normalization of eating patterns and nutritional status. RDs provide nutritional counseling, recognize clinical signs related to eating disorders, and assist with medical monitoring while cognizant of psychotherapy and pharmacotherapy that are cornerstones of eating disorder treatment. Specialized resources are available for RDs to advance their level of expertise in the field of eating disorders. Further efforts with evidenced-based research must continue for improved treatment outcomes related to eating disorders along with identification of effective primary and secondary interventions.
Masheb, Robin M; Roberto, Christina A; White, Marney A
The goal of this study was to examine the clinical utility of nibbling behavior, defined as eating in an unplanned and repetitious manner between meals and snacks without a sense of loss of control, in obese patients with Binge Eating Disorder (BED). Two-hundred seventeen (N = 217) consecutive, treatment-seeking, obese patients with BED were assessed with the Eating Disorder Examination (EDE). Nibbling frequency was examined in relation to current weight, eating disorder psychopathology and eating patterns. Results found that nibbling/picking was not related to body mass index, objective bulimic, subjective bulimic, or overeating episodes, food avoidance, sensitivity to weight gain, or any subscales of the EDE. However, nibbling/picking was significantly related to frequency of morning and afternoon snacking (r = .21, p = .002; r = .27, p < .001). The assessment of nibbling/picking behaviors among individuals with BED might not provide clinically significant information. © 2013.
Sim, Leslie A; Lebow, Jocelyn; Weiss, Karen; Harrison, Tracy; Bruce, Barbara
Given that youth with chronic pain frequently experience disruptions in eating patterns that may place them at risk for disordered eating, the purpose of this study was to examine the clinical characteristics and illness course of adolescents with chronic pain and comorbid eating disorders. Using a retrospective chart review, 34 adolescents with chronic pain and concurrent eating disorders were identified. These adolescents were compared with 34 age-, gender-, and eating disorder symptom-matched adolescents who had an eating disorder without chronic pain. The majority of adolescents with chronic pain and an eating disorder had a primary medical diagnosis of abdominal pain (n = 14), followed by autonomic dysfunction (n = 10) and headache (n = 6). Although in 41.2% of teens with chronic pain, eating disorder symptoms developed after the onset of their pain, 35.3% reported having eating disorder symptoms before they experienced chronic pain. Body mass index did not differ between the groups, but the duration of eating disorder symptoms was significantly longer for the chronic pain group (p eating disorders are undetected for longer periods in patients with chronic pain, which may contribute to a poorer prognosis. Implications for eating disorder conceptualization, detection, and treatment are discussed. Copyright © 2016. Published by Elsevier Inc.
Forsberg, S; Lock, J
Perfectionism is a potentially maladaptive personality trait implicated in a number of psychopathologies. As our understanding of the construct perfectionism has shifted from more unidimensionally focused conceptualizations to multidimensional ones, our ability to assess its bearing on various disorders has grown. One particular area in which perfectionism appears to play an important role is among eating disorder patients. The personalities of both those with anorexia nervosa (AN) and bulimia nervosa (BN) are thought to be intrinsically perfectionistic, which suggests a need to understand the role perfectionism plays in the development, course and outcome of these disorders. There is also an increased focus on perfectionism among athletes and its relationship to the higher prevalence of eating disorders in this group. With the institution of Title IX in the United States (which prohibited sex discrimination in higher educational settings) the participation of women in various sports has increased exponentially and with it concerns about their well-being in a milieu where a risk for menstrual irregularities, osteoporosis and eating disorders (the female athlete triad) are common. However, conflicting data suggests that athletics may be a protective factor in the development of eating disorders on the one hand, or it may be a risk factor on the other. Thus, it has become important to examine other variables, such as perfectionism, that may influence the outcome, one way or another. This review examines the current evidence about the relations between perfectionism, athletics and eating disorders.
Fernández-Aranda, Fernando; Pinheiro, Andréa Poyastro; Thornton, Laura M; Berrettini, Wade H; Crow, Scott; Fichter, Manfred M; Halmi, Katherine A; Kaplan, Allan S; Keel, Pamela; Mitchell, James; Rotondo, Alessandro; Strober, Michael; Woodside, D Blake; Kaye, Walter H; Bulik, Cynthia M
We compared symptom patterns, severity of illness, and comorbidity in individuals with eating disorders with and without impulse control disorders (ICD), and documented the temporal pattern of illness onset. Lifetime ICD were present in 16.6% of 709 women with a history of eating disorders. The most common syndromes were compulsive buying disorder and kleptomania. ICD occurred more in individuals with binge eating subtypes, and were associated with significantly greater use of laxatives, diuretics, appetite suppressants and fasting, and with greater body image disturbance, higher harm avoidance, neuroticism, cognitive impulsivity, and lower self-directedness. In addition, individuals with ICD were more likely to have obsessive-compulsive disorder, any anxiety disorder, specific phobia, depression, cluster B personality disorder, avoidant personality disorder, and to use psychoactive substances. Among those with ICD, 62% reported the ICD predated the eating disorder and 45% reported the onset of both disorders within the same 3-year window. The presence of a lifetime ICD appears to be limited to eating disorders marked by binge eating and to be associated with worse eating-related psychopathology, more pathological personality traits, and more frequent comorbid Axis I and II conditions. Untreated ICD may complicate recovery from eating disorders.
Full Text Available Background: Eating Disorders (EDs are characterized by a persistent disturbance of eating or eating-related behavior that significantly impairs physical health or psychosocial functioning. EDs are caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. Their epidemiology is rising for the past decades, and EDs affect all races, social levels and both genders. Due to the long and expensive treatment, chronic course, and the fact that most of the sufferers do not realize the need for therapy or do not seek treatment, the demand on developing prevention programs, early detection and assessment is essential. Despite the fact, that many new EDs screening tools were developed already, there is a great lack of validated screening instruments, adapted to the Bulgarian conditions. Objects and methods: Our study aimed at eliciting a comprehensive battery for screening of not only specific ED pathology, but also some risk factors, such as negative body image, weight and depressive symptoms. The object of our study consisted of 201 females, aged 18 to 45 (mean 24.65. SCOOF- questionnaire, Eating Disorder Diagnostic Scale (EDDS-5, Body Image Questionnaire-34 and Beck Depression Inventory (BDI were applied. Results: Our preliminary results show that approximately 45% of the tested subjects show some of the: negative body image, eating disorders’ clinical pathology, distorted eating patterns, subclinical eating disorders pathology, overweight/obesity, or depressive symptoms. Conclusion: Our ongoing efforts in area of research also are aimed at developing and refining strategies for preventing and treating ED among adolescents and adults.
Ignacio Jáuregui Lobera
Full Text Available Ignacio Jáuregui Lobera1, Patricia Bolaños Ríos21Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain; 2Behavior Sciences Institute, Seville, SpainPurpose: The objective was to examine how body image affects quality of life in an eating-disorder (ED clinical sample, a non-ED clinical sample, and a nonclinical sample. We hypothesized that ED patients would show the worst body image quality of life. We also hypothesized that body image quality of life would have a stronger negative association with specific ED-related variables than with other psychological and psychopathological variables, mainly among ED patients. On the basis of previous studies, the influence of gender on the results was explored, too.Patients and methods: The final sample comprised 70 ED patients (mean age 22.65 ± 7.76 years; 59 women and 11 men; 106 were patients with other psychiatric disorders (mean age 28.20 ± 6.52; 67 women and 39 men, and 135 were university students (mean age 21.57 ± 2.58; 81 women and 54 men, with no psychiatric history. After having obtained informed consent, the following questionnaires were administered: Body Image Quality of Life Inventory-Spanish version (BIQLI-SP, Eating Disorders Inventory-2 (EDI-2, Perceived Stress Questionnaire (PSQ, Self-Esteem Scale (SES, and Symptom Checklist-90-Revised (SCL-90-R.Results: The ED patients' ratings on the BIQLI-SP were the lowest and negatively scored (BIQLI-SP means: +20.18, +5.14, and —6.18, in the student group, the non-ED patient group, and the ED group, respectively. The effect of body image on quality of life was more negative in the ED group in all items of the BIQLI-SP. Body image quality of life was negatively associated with specific ED-related variables, more than with other psychological and psychopathological variables, but not especially among ED patients.Conclusion: Body image quality of life was affected not only by specific pathologies related to body
Kindermann, Sally; Moessner, Markus; Ozer, Fikret; Bauer, Stephanie
Flexible, individualized interventions allow participants to adjust the intensity of support to their current needs. Between-persons, participants with greater needs can receive more intense support, within-persons, participants can adjust utilization to their current level of symptoms. The purpose of the present study was to analyze associations between ED-related symptoms and utilization of the individualized program ProYouth both between- and within-persons, aiming to investigate whether participants adapt utilization intensity to their current needs. Generalized estimated equations (GEEs) were used to analyze log data on program utilization (monthly page visits, monthly use of chats and forum) assessed via server logs and self-reported data on ED-related symptoms from N = 394 ProYouth participants who provided longitudinal data for at least two months. Between-persons, page visits per month were significantly associated with compensatory behavior, body dissatisfaction, and binge eating. Monthly use of the more intense modules with personal support chat and forum was associated with the frequency of compensatory behavior. Within-persons, unbalanced nutrition and dieting showed the strongest associations with monthly page visits. Monthly use of chats and forum was significantly associated with compensatory behavior and unbalanced nutrition and dieting. Results indicate that program utilization is associated with ED-related symptoms between- as well as within-persons. The individualized, flexible approach of ProYouth thus seems to be a promising way for Internet-based provision of combined prevention and early intervention programs addressing ED. © 2017 Wiley Periodicals, Inc.
Berner, Laura A; Feig, Emily H; Witt, Ashley A; Lowe, Michael R
Prior research suggests that both body mass index (BMI) and weight suppression (highest past weight minus current weight; WS) are important in determining adult anorexia nervosa (AN) severity. We examined associations between amenorrhea and WS, DSM-5 BMI severity category, and highest premorbid BMI among patients with AN. Participants (N = 69) were adult female AN-spectrum patients at two residential treatment facilities. At admission, height, and weight were measured, and participants completed questionnaires assessing menstrual status and weight history. Greater WS, adjusted for BMI, was associated with menstrual function at admission. First amenorrhea onset occurred at a normal BMI for 38.5% of participants. Premorbid highest BMI positively correlated with BMI at amenorrhea onset, and higher BMI at amenorrhea onset was associated with higher BMI at menses resumption. These findings add to the literature indicating that relative and absolute weight status are dual indicators of illness severity in AN, and preliminarily suggest that a large proportion of adults who present for treatment initially may have shown symptoms of starvation at a normal BMI. Results underscore the need to focus on weight loss in early detection efforts and may inform target weight setting in the treatment of AN. © 2017 Wiley Periodicals, Inc.
Davidsen, Annika Helgadóttir; Hoyt, William T.; Poulsen, Stig Bernt
Purpose: The aim was to examine duration of illness and body mass index as possible moderators of the relationship between eating disorder severity and functional impairment, as well as psychological distress as a possible mediator of this relationship. Methods: The study included 159 patients...... diagnosed with bulimia nervosa, binge eating disorder or eating disorder not otherwise specified. Regression analysis was applied to assess the effect of the hypothesized moderators and mediators. Eating disorder severity was measured with the Eating Disorder Examination Questionnaire, functional impairment...... was measured with the Sheehan Disability Scale, and psychological distress was measured with the Symptom Check List-90-R. Duration of illness and body mass index were assessed clinically. Results: Duration of illness significantly moderated the relationship between eating disorder severity and functional...
Muuss, Rolf E.
Defines bulimia and lists associated features of bulimia, physical side effects, and cognitive disturbances related to binging and purging. Asserts that bulimics resist treatment; but that such methods as cognitive, group, family, behavior, and drug therapy, and hospitalization appear promising. (Author/ABB)
Papp, Ildikó; Szumska, Irena; Túry, Ferenc
The binge eating disorder is a relatively new type of eating disorders, which was first described in 1992, and became a distinct nosological entity in the system of DSM-5 in 2013. Its central symptom is the binge, which is not followed by compensatory behaviours as in bulimia nervosa. Therefore, the patients are generally obese. The prevalence of the disorder is 1-3% in the general population, but much higher in help-seeking obese subjects. The two main goals of the therapy is body weight reduction, and the cessation of binges. In the pharmacotherapy of binge eating disorder the antidepressants are recommended mainly in the case of unsuccessful psychotherapy, and in treating comorbid depression. In the field of psychotherapy data are available mainly on the effectiveness of cognitive behavioural therapy, dialectic behaviour therapy, behavioural weight loss, and interpersonal therapy. Effectivity studies on new therapeutic methods and treatment combinations are needed as well as long term follow-up studies.
Schreiber, Liana R N; Odlaug, Brian Lawrence; Grant, Jon E
BACKGROUND AND AIMS: Binge eating disorder (BED) is a relatively common condition, especially in young adult females, and is characterized by chronic over-consumption of food resulting in embarrassment, distress, and potential health problems. It is formally included as a disorder in DSM-5...... for the first time, an acknowledgement to its debilitating nature. This article explores the overlap between binge eating disorder and substance use disorders (SUD). METHODS: The bibliographic search was a computerized screen of PubMed databases from January 1990 to the present. Binge eating disorder, substance...... use disorder, binging, obesity, food addiction, comorbidity, dopamine, opioid, serotonin, glutamate, and pharmacological treatment were the keywords used in searching. RESULTS: BED shares similar phenomenology to SUD, including significant urges to engage in binging episodes, resulting in distress...
Brewerton, Timothy D
The application of modern neurobiological probes to the field of eating disorders has yielded new and exciting insights into the underlying mechanisms and causes of these devastating conditions. Findings from neuroimaging studies and genetic investigations have further confirmed and expanded our understanding of the role of the serotonin system in anorexia nervosa (AN) and bulimia nervosa. In addition, reduced regional cerebral blood flow in the temporal lobes and related brain structures have been identified in patients with AN, even after recovery. These data may hold promise for the development of more effective treatment strategies for these often chronic and refractory conditions. Results of reported treatment studies demonstrate the role and effectiveness of psychotherapy for AN and 'eating disorder not otherwise specified'; two eating disorders for which there is a paucity of empirically based treatments. Finally, more results from open studies of atypical antipsychotic medications in the treatment of AN are encouraging.
Waller, Glenn; Mountford, Victoria A; Tatham, Madeleine; Turner, Hannah; Gabriel, Chloe; Webber, Rebecca
Clinicians have relatively low uptake and implementation of evidence-based psychotherapies for the eating disorders, and this problem appears to be associated with low use of manualized approaches. This study examines clinicians' positive and negative attitudes to manuals, and possible beliefs and emotional factors that might drive those attitudes. The participants were 125 psychological therapists working with eating-disordered patients. Each completed standardised measures of attitudes to manuals and emotional states. A number of beliefs about the content of manuals were associated with both positive attitudes to the outcome of treatment and negative attitudes to their impact on the treatment process. In addition, a more positive mood was associated with more positive attitudes. Suggestions are made regarding how attitudes might be made more positive, in order to facilitate the use of evidence-based therapies for eating disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.
Murphy, Rebecca; Straebler, Suzanne; Cooper, Zafra; Fairburn, Christopher G.
Cognitive behavioral therapy (CBT) is the leading evidence-based treatment for bulimia nervosa. A new ?enhanced? version of the treatment appears to be more potent and has the added advantage of being suitable for all eating disorders, including anorexia nervosa and eating disorder not otherwise specified. This article reviews the evidence supporting CBT in the treatment of eating disorders and provides an account of the ?transdiagnostic? theory that underpins the enhanced form of the treatme...
Full Text Available Eating disorders are some of the most severe and destructive of all psychological conditions. They are associated with restricted capacities in cognitive, emotional, physical, and spiritual development. This paper provides an examination of the practical application of Christian spirituality as a force for recovery from an eating disorder. Specifically, it expounds the transformative potential in the spiritual qualities of hope, trust, acceptance, surrender, and courage underpinning engagement with evidence-based therapeutic models of care in eating disorder recovery.
This thesis explores the epidemiology and risk factors of eating disorders. It focuses on the impact of the political and cultural changes that occured in the Czech Republic in the early 1990s. The term eating disorders includes mental illnesses characterized by disturbances in eating behaviour: anorexia nervosa, bulimia nervosa and various eating disorders not otherwise specifieed. It appears that the incidence of anorexia nervosa was increasing until 1970s and remains stable since. The inci...
Carton, Amelia Myri; Smith, Alastair D
Previous research demonstrates a genetic and behavioural link between eating disorders and autism spectrum disorders, and a recent study (Coombs et al. in Br J Clin Psychol 50:326-338, 2011) extends this link to typical populations, showing a positive correlation between behaviours in typically developing children. The purpose of the present study was to examine whether this relationship continues beyond development, by studying the link between behaviours in a non-clinical adult population. We examined associations between performance on measures relating to autistic traits and disordered eating. Undergraduate students, equally balanced by gender and by subject studied (i.e. humanity or science), completed three tasks: to measure autistic traits, participants were administered the Embedded Figures Test (EFT) and the Autism-Spectrum Quotient (AQ). Eating disorder symptomatology was measured by the Eating Attitudes Test (Eat-26). Our data revealed a significant positive correlation between scores on the AQ and Eat-26. Multiple linear regressions showed that higher scores on the AQ were particularly associated with higher scores on the Bulimia & Food Preoccupation subscale of the Eat-26. EFT performance was positively related to behaviours associated with autism and eating disorders, although not reliably so. These data support the broader link between autistic traits and disordered eating in the non-clinical population, and demonstrate that it extends into adulthood (a time at which autistic behaviours can decrease). This work carries implications for the development of cognitive therapies for people with eating disorders.
Haines, Jess; Neumark-Sztainer, Dianne
In response to the high prevalence of obesity, eating disorders and disordered eating behaviors among youth, researchers in both the obesity and eating disorders fields have proposed using an integrated approach to prevention that addresses the spectrum of weight-related disorders within interventions. The identification of risk factors that are…
McElroy, Susan L.; Frye, Mark A.; Hellemann, Gerhard; Altshuler, Lori; Leverich, Gabriele S.; Suppes, Trisha; Keck, Paul E.; Nolen, Willem A.; Kupka, Ralph; Post, Robert M.
Objective: Relatively little is known about the co-occurrence of bipolar and eating disorders. We therefore assessed the prevalence and clinical correlates of eating disorders in 875 patients with bipolar disorder. Method: 875 outpatients with DSM-IV bipolar I or II disorder were evaluated with
Svedlund, Nils Erik; Norring, Claes; Ginsberg, Ylva; von Hausswolff-Juhlin, Yvonne
Very little is known about the prevalence of ADHD symptoms in Bulimia Nervosa and Binge Eating Disorder and even less in other eating disorders. This knowledge gap is of clinical importance since stimulant treatment is proven effective in Binge Eating Disorder and discussed as a treatment possibility for Bulimia Nervosa. The objective of this study was to explore the prevalence and types of self-reported ADHD symptoms in an unselected group of eating disorder patients assessed in a specialized eating disorder clinic. In total 1165 adults with an eating disorder were assessed with a battery of standardized instruments, for measuring inter alia ADHD screening, demographic variables, eating disorder symptoms and psychiatric comorbidity. Chi-square tests were used for categorical variables and Kruskal-Wallis tests for continuous variables. Almost one third (31.3 %) of the patients scored above the screening cut off indicating a possible ADHD. The highest prevalence rates (35-37 %) were found in Bulimia Nervosa and Anorexia Nervosa bingeing/purging subtype, while Eating Disorder Not Otherwise Specified type 1-4 and Binge Eating Disorder patients reported slightly below average (26-31 %), and Anorexia Nervosa restricting subtype patients even lower (18 %). Presence of binge eating, purging, loss of control over eating and non-anorectic BMI were related to results indicating a possible ADHD. Psychiatric comorbidity correlated to ADHD symptoms without explaining the differences between eating disorder diagnoses. There is a high frequency of ADHD symptoms in patients with binge eating/purging eating disorders that motivates further studies, particularly concerning the effects of ADHD medication. The finding that the frequency of ADHD symptoms in anorexia nervosa with binge eating/purging is as high as in bulimia nervosa highlights the need also for this group.
Eating disorders are severe and disabling mental disorders. The scientific study of eating disorders has expanded dramatically over the past few decades, and provided significant understanding of eating disorders and their treatments. Those significant advances notwithstanding, there is scant knowledge about key processes that are crucial to clinical improvement. The lack of understanding mechanisms that cause, maintain and change eating disorders, currently is the biggest problem facing the science of eating disorders. It hampers the development of really effective interventions that could be fine-tuned to target the mechanisms of change and, therefore, the development of more effective treatments. It is argued here that the science of eating disorders and eating disorder treatment could benefit tremendously from pure experimental studies into its mechanisms of change, that is, experimental psychopathology (EPP). To illustrate why eating disorders need more EPP research, some key symptoms - restriction of intake, binge eating and body overvaluation - will be discussed. EPP studies challenge some generally accepted views and offer a fresh new look at key symptoms. This will, consequently, better inform eating disorder treatments. Copyright © 2016. Published by Elsevier Ltd.
Eating disorders are a complex set of illnesses most commonly affecting white adolescent girls and young women. The most common eating disorders seen in the primary care setting are anorexia nervosa, bulimia nervosa, and binge eating disorder. Treatment in the primary care environment ideally involves a physician, therapist, and nutritionist, although complex cases may require psychiatric and other specialist care. Early diagnosis and treatment are associated with improved outcomes, whereas the consequences of untreated eating disorders, particularly anorexia nervosa, can be devastating, including death. Copyright © 2016 Elsevier Inc. All rights reserved.
Raevuori, Anu; Keski-Rahkonen, Anna; Hoek, Hans W
Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition has outlined more sex-neutral diagnostic criteria for eating disorders. Data of socioeconomic factors, prenatal influences, clinical characteristics, assessment, and mortality for eating disorders have been reported independently for males. Unlike in females, higher parental education showed no association with eating disorders in males, but twin or triplet status and lower gestational age at birth had an independent association with anorexia nervosa in males. Contrary to earlier suggestions, no differences in eating disorder symptoms such as binging, vomiting, or laxative abuse were observed between the sexes. Yet, males tended to score lower on eating disorder symptom measures than females. High rates of premorbid overweight and higher BMIs at various stages of eating disorders have been confirmed repeatedly. Higher age and lower BMI at admission, and restrictive anorexia nervosa subtype predicted fatal outcome for anorexia nervosa in males. Contemporary research provides grounds for improved recognition, diagnosis, and treatment for males suffering from eating disorders.
Blodgett Salafia, Elizabeth H.; Jones, Maegan E.; Haugen, Emily C.; Schaefer, Mallary K.
Background In this study, we examined perceptions regarding the causes of eating disorders, both among those with eating disorders as well as those without. By understanding the differences in perceived causes between the two groups, better educational programs for lay people and those suffering from eating disorders can be developed. Method This study used open-ended questions to assess the beliefs of 57 individuals with self-reported eating disorders and 220 without. Participants responded ...
Thomas, Jennifer J; Lee, Sing; Becker, Anne E
This review summarizes and contextualizes the recent epidemiologic data on eating disorders in the Asia and Pacific regions. Gaps in epidemiologic data on eating disorders from the Asia and Pacific regions stem, in part, from omission of eating disorder-specific assessments in large nationally representative cohort studies of mental disorders. Available data - often from clinical and school-going cohorts - support that the prevalence of both eating disorders and associated attitudes and behaviors in many Asian and Pacific regions studied may be comparable to those reported in Europe and North America. Moreover, the prevalence of eating disorders in some regions of Asia may be increasing. Some of the national and subnational regions with the highest annual percent increases in disability-adjusted life years per 100 000 caused by eating disorders over the past two decades are located in Asia. Notwithstanding sparse epidemiologic data concerning eating disorders in Asia and the Pacific, available evidence supports comparable prevalence to other global regions and that associated health burdens in some regions of Asia may be rising. This further supports that eating disorders are trans-national in distribution and challenges the previous understanding that they were primarily culture-bound to the Global North.
Eating disorders involve serious disturbances in eating behavior, such as extreme and unhealthy reduction of food intake or severe overeating, as well as feelings of distress or extreme concern about body shape or weight. Anorexia nervosa and bulimia nervosa are the two main types of eating disorders. Eating disorders frequently co-occur with…
Yilmaz, Zeynep; Hardaway, J. Andrew; Bulik, Cynthia M.
Eating disorders (EDs) are serious psychiatric conditions influenced by biological, psychological, and sociocultural factors. A better understanding of the genetics of these complex traits and the development of more sophisticated molecular biology tools have advanced our understanding of the etiology of EDs. The aim of this review is to critically evaluate the literature on the genetic research conducted on three major EDs: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). We will first review the diagnostic criteria, clinical features, prevalence, and prognosis of AN, BN, and BED, followed by a review of family, twin, and adoption studies. We then review the history of genetic studies of EDs covering linkage analysis, candidate gene association studies, genome-wide association studies, and the study of rare variants in EDs. Our review also incorporates a translational perspective by covering animal models of ED-related phenotypes. Finally, we review the nascent field of epigenetics of EDs and a look forward to future directions for ED genetic research. PMID:27013903
Bydlowski, Sarah; Corcos, Maurice; Jeammet, Philippe; Paterniti, Sabrina; Berthoz, Sylvie; Laurier, Catherine; Chambry, Jean; Consoli, Silla M
First, we measured both emotional awareness and alexithymia to understand better emotion-processing deficits in eating disorder patients (EDs). Second, we increased the reliability of the measures by limiting the influence of confounding factors (negative affects). Seventy females with eating disorders were compared with 70 female controls. Participants completed the Beck Depression Inventory (BDI; depression), the Hospital and Anxiety Depression Scale (HADS; anxiety), the Toronto Alexithymia Scale (TAS; alexithymia), and the Level of Emotional Awareness Scale (LEAS). EDs exhibited higher alexithymia scores and lower LEAS scores, with an inability to identify and describe their own emotions, as well as an impairment in mentalizing others' emotional experience. Whereas alexithymia scores were related to depression scores, LEAS scores were not. After controlling for depression, alexithymia scores were similar in EDs and controls. The marked impairment in emotion processing found in EDs is independent of affective disorders. Thus, the joint use of TAS and LEAS suggests a global emotion-processing deficit in EDs. Copyright 2005 by Wiley Periodicals, Inc
Culbert, Kristen M; Racine, Sarah E; Klump, Kelly L
This review summarizes the current state of the literature regarding hormonal correlates of, and etiologic influences on, eating pathology. Several hormones (e.g., ghrelin, CCK, GLP-1, PYY, leptin, oxytocin, cortisol) are disrupted during the ill state of eating disorders and likely contribute to the maintenance of core symptoms (e.g., dietary restriction, binge eating) and/or co-occurring features (e.g., mood symptoms, attentional biases). Some of these hormones (e.g., ghrelin, cortisol) may also be related to eating pathology via links with psychological stress. Despite these effects, the role of hormonal factors in the etiology of eating disorders remains unknown. The strongest evidence for etiologic effects has emerged for ovarian hormones, as changes in ovarian hormones predict changes in phenotypic and genetic influences on disordered eating. Future studies would benefit from utilizing etiologically informative designs (e.g., high risk, behavioral genetic) and continuing to explore factors (e.g., psychological, neural responsivity) that may impact hormonal influences on eating pathology.
Portzky, Gwendolyn; van Heeringen, Kees; Vervaet, Myriam
Suicide is a major cause of mortality for patients with eating disorders (ED), especially for patients with anorexia nervosa. Attempted suicide is also relatively common in patients with anorexia or bulimia nervosa. This study aimed at examining associations between attempted suicide and trait- and state-dependent characteristics in a large clinical population of ED patients. The sample consisted of 1,436 in- and outpatients of the Centre for Eating Disorders of the Ghent University Hospital. Measures of ED symptoms, psychopathology, and personality traits were compared between ED patients with and ED patients without a history of attempted suicide. A history of attempted suicide was found in 11.8% of the ED patients and lifetime suicidal ideation was reported by 43.3%. Multivariate analyses showed that a history of attempted suicide was associated with higher scores on depression, purging symptomatology, early-developed cognitive schemes (impaired autonomy and increased inhibition), and social insecurity. These findings support the increased risk of suicidal behavior in ED. The presence of particular personality traits, of cognitive schemes, and of purging and depressive symptoms should increase vigilance for suicidal behavior.
Capasso, Anna; Putrella, Claudio; Milano, Walter
This review focuses on Eating Disorders (ED), the role played by neurotransmitters and peptides in ED phenomena as well as the drugs used in the treatment of these diseases. For ED, we mean a syndrome characterized by persistent alteration of eating behavior and the conditions that cause an insufficient ingestion and/or adsorption of foods. There are three different ED diseases: Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorders (BED). ED are complex conditions that arise from a combination of long-standing behavioral, emotional, psychological, interpersonal, and social factors. The neuronal circuits that control the ingestion of food are mainly related to catecholaminergic, serotoninergic and peptidergic systems. In this respect, while serotonin, dopamine and prostaglandin promote the ingestion of food, by contrast, neuropeptide Y, norepinephrine, GABA and opioid peptides inhibit food ingestion, thus, causing the occurence of ED. The drugs mainly used in the treatment of ED are antidepressants such as selective serotonin reuptake inhibitors and tricyclic antidepressants. Additionally, mood stabilizers (lithium), anxiolytics, serotonin and noradrenalin reuptake inhibitors and antipsychotic drugs are often used in the treatment of ED.
van Elburg, Annemarie; Treasure, Janet
To systematize new neurobiological findings on the cause and treatment of eating disorders. The conceptual framework of the cause of eating disorders has undergone great changes in the past decades. Recently, the National Institute of Mental Health proposed a new set of criteria for research purposes--the Research Domain Criteria (RDoC). We aim to structure this study as much as possible using these constructs across biological units of analysis, summarizing new findings. Brain imaging techniques have become sophisticated in identifying brain circuits related to illness behaviour and to fundamental traits such as reward and social processing. Genetic studies have moved from candidate gene studies onto genome-wide association studies; however, the field needs to cooperate to collect larger samples in order to benefit from this approach. Hormonal changes as the results of starvation or as underlying factors for behavioural changes still receive attention in both animal and human studies. Advances made in neuropsychology show problems in cognition (set shifting and central coherence) and in other RDoC domains. Some of these findings have been translated into treatment. New biological models are being developed which explain causal and maintaining factors. The RDoC construct may be used to systematize these findings.
Toro, Josep; Guerrero, Marta; Sentis, Joan; Castro, Josefina; Puértolas, Carles
To study the prevalence of symptoms of eating disorders and risk eating behaviours and the relationship between life at a dance school and the risk of developing an eating disorder (ED) in an adolescent population of Spanish dance students. Questionnaires were used to assess attitudes to eating, cultural influences on the body shape model, eating disorders (DSM-IV) and risk factors for eating disorders in 76 adolescent dance students (age 12-17 years) at the Barcelona Theatre Institute. Subjects were compared with a community sample of 453 female adolescents. To study the relationship between ED and characteristics of this particular school, an original questionnaire was administered to 105 students at the school aged from 12 to 21 years. The prevalence of eating disorders and several risk attitudes and behaviours were similar in the dance students and the female adolescents from the general population. Students at risk of eating disorders perceived greater pressure from coaches concerning eating, appearance, weight and artistic performance; they felt less satisfied with their weight and weighed themselves more often; they avoided performing so as not to exhibit their body in public, disliked comparing their body with their peers and believed that audiences paid a great deal of attention to their bodies. In contrast, Body Mass Index (BMI) had hardly any influence on these experiences. Depressive symptoms were associated almost exclusively with experience of stressors and aversive situations. Dance school students do not necessarily present a greater risk of ED than other girls of the same age. The risk of ED may be associated with greater pressure from coaches, with attitudes related to the ED itself, or with depressive symptoms, rather than with the BMI.
Averett, Susan; Terrizzi, Sabrina; Wang, Yang
Eating disorders are currently the deadliest mental disorder in the United States, affecting an estimated 12%-25% of all college women. Previous research has found a positive correlation between sorority membership and eating disorders, but the causal link has not been firmly established. We contribute to the literature by investigating a possible causal link among sororities and diagnosed eating disorders, measurable weight outcomes, and disordered-eating behaviors using data from the American College Health Association Survey. We handle the potential endogeneity of sorority membership using propensity score matching and instrumental variable methods to determine whether joining a sorority is a cause of the weight-related outcomes we study. We find that sorority members exhibit worse weight-related outcomes than those not in a sorority. However, our propensity score matching and instrumental variable results suggest that, other than BMI, this is merely a correlation, and there is little evidence that sorority membership is a cause of the outcomes we study. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.
Prior, Amie-Louise; Woodward, Debbie; Hoefkens, Toni; Clayton, Debbie; Thirlaway, Katie; Limbert, Caroline
Access to care for eating disorders can be problematic for numerous reasons including lack of understanding and delays with treatment referrals. Previous research has highlighted the benefits of telephone helplines as an accessible source of support for those who may not wish to access face-to-face support or to fill a gap for those waiting for treatment. This study aimed to gain an insight into the perspectives of those who may use or refer others to a telephone helpline in order to identify the requirements of such a service. Triangulation of service user, carer and health professionals' perspectives resulted in identification of themes relating to the type of support, delivery and practicalities of a helpline. The findings indicated that telephone helplines may offer numerous benefits for individuals with an eating disorder, whether accessed as a first step, alongside treatment or as an extension of this support when in recovery. Additionally helplines may provide an opportunity for carers to access information and discuss their own experiences, while supporting their loved one. Raising awareness of these services is important to encourage those affected by an eating disorder to access and make the most of this type of support. These findings offer an insight into the key requirements for new and existing service development with regard to both the type of support and the method of communication required by individuals with eating disorders.
Holtom-Viesel, Anita; Allan, Steven
The objectives of this review were to systematically identify and evaluate quantitative research comparing family functioning (a) in eating disorder families with control families, (b) in families with different eating disorder diagnoses (c) perceptions of different family members and (d) the relationship between family functioning and recovery. This adds to the findings of previous reviews of family functioning by including data from control families, the range of diagnoses, and focusing on recovery. Findings were considered in relation to models of family functioning. Using specific search criteria, 17 research papers were identified and evaluated. Findings indicated that eating disorder families reported worse family functioning than control families but there was little evidence for a typical pattern of family dysfunction. A consistent pattern of family dysfunction for different diagnoses was not suggested but patients consistently rated their family as more dysfunctional than one or both of their parents. With respect to outcome and recovery, those with more positive perceptions of family functioning generally had more positive outcomes, irrespective of severity of eating disorder. Conclusions were limited by inconsistent findings and methodological issues. Further research is needed into the relationship between family functioning and outcome and the assessment of family functioning beyond self-report. © 2013.
Garrusi, Behshid; Baneshi, Mohammad Reza
Many socio cultural variables could be affect eating disorders in Asian countries. In Iran, there are few researches regarding eating disorders and their contributing factors. The aim of this study is to explore frequency of eating disorders and their risk factors in an Iranian population. About 1204 participants were selected aged between fourteen to 55 years. Frequency of eating disorders and effects of variables such as demographic characteristics, Body Mass Index (BMI), use of media, body dissatisfaction, self-esteem, social comparison and social pressure for thinness in individuals with and without eating disorders, were assessed. The prevalence of eating disorders was 11.5% that included 0.8% anorexia nervosa, 6.2% full threshold bulimia nervosa, 1.4% sub threshold anorexia nervosa and 30% sub threshold binge eating disorder. Symptoms of bulimic syndrome were greater in males. In Iran, eating disorders and related problems are new issue that could be mentioned seriously The identification of these disorders and their related contributing factors are necessity of management and preventive programs planning.
Tzischinsky, Orna; Latzer, Yael
Sleep wake cycle and eating patterns undergo major changes during the adolescent period. Most of the new sleeping and eating patterns come within normal range, and therefore, it is important to differentiate them from pathologicaL eating and sleeping behavior Over the Last decades there has been a dramatic increase in the prevalence of eating disorders (ED) in western society. The main syndromes are anorexia nervosa (AN), buLimia nervosa (BN) and non-specified eating disorders (ED-NOS). These disorders are linked with high morbidity and life-threatening complications. Sleep disturbances are a predominant symptom in these disorders. To date, research studies have examined sleep disorders among people suffering from eating disorders, mainly using polysomnographic monitoring. However, the research presented in these studies used ambulatory monitoring (actigraph) in a natural environment over the period of a week, as well as subjective sleep monitoring. This paper describes three different research studies that were held in Israel. Each research monitors the sleep-wake cycle among adolescents and young adult females suffering from anorexia nervosa, bulimia nervosa and binge eating behavior and compares them to a healthy control group of similar age and socioeconomic status. ' At the outset of each research study, the diagnostic and clinical characteristics of the eating disorder related to the group examined are briefly described. In conclusion, the results are discussed in light of the previous literature as well as the discrepancies between the subjective and objective results. In addition, further research is suggested with relation to the connection between eating and sleeping disorders and to psychiatric comorbidity, nutrition intake, BMI, activity level and weight fluctuations.
Lydecker, Janet A.; Grilo, Carlos M.
Objective A limited literature suggests an association between maternal eating disorders and child feeding difficulties, and notes maternal concern about inadvertently transmitting eating disorders. Thus, parents may be an important target for eating-disorder research to guide the development of clinical programs. Methods The current study examined differences in child eating-disorder behaviors and parental feeding practices between a sample of parents (42 fathers, 130 mothers) exhibiting core features of anorexia nervosa, bulimia nervosa, binge-eating disorder, or purging disorder, and a matched sample of parents (n=172) reporting no eating-disorder characteristics. Results Parents with eating-disorder psychopathology were significantly more likely than parents without eating-disorder characteristics to report child binge-eating and compulsive exercise. Parents with eating-disorder psychopathology reported greater perceived feeding responsibility, greater concern about their child’s weight, and more monitoring of their child’s eating than parents without eating-disorder characteristics; however, they did not differ significantly in restriction of their child’s diet and pressure-to-eat. Child body mass index z-scores did not differ between parents with versus without eating-disorder characteristics. Conclusion Our findings suggest some important differences between parents with and without core eating-disorder psychopathology, which could augment clinical interventions for patients with eating disorders who are parents, or could guide pediatric eating-disorder prevention efforts. However, because our study was cross-sectional, findings could indicate increased awareness of or sensitivity to eating-disorder behaviors rather than a psychosocial cause of those behaviors. Longitudinal research and controlled trials examining prevention and intervention can clarify and address these clinical concerns. PMID:27302549
Lydecker, Janet A; Grilo, Carlos M
A limited literature suggests an association between maternal eating disorders and child feeding difficulties, and notes maternal concern about inadvertently transmitting eating disorders. Thus, parents may be an important target for eating-disorder research to guide the development of clinical programs. The current study examined differences in child eating-disorder behaviors and parental feeding practices between a sample of parents (42 fathers, 130 mothers) exhibiting core features of anorexia nervosa, bulimia nervosa, binge-eating disorder, or purging disorder, and a matched sample of parents (n=172) reporting no eating-disorder characteristics. Parents with eating-disorder psychopathology were significantly more likely than parents without eating-disorder characteristics to report child binge-eating and compulsive exercise. Parents with eating-disorder psychopathology reported greater perceived feeding responsibility, greater concern about their child's weight, and more monitoring of their child's eating than parents without eating-disorder characteristics; however, they did not differ significantly in restriction of their child's diet and pressure-to-eat. Child body mass index z-scores did not differ between parents with versus without eating-disorder characteristics. Our findings suggest some important differences between parents with and without core eating-disorder psychopathology, which could augment clinical interventions for patients with eating disorders who are parents, or could guide pediatric eating-disorder prevention efforts. However, because our study was cross-sectional, findings could indicate increased awareness of or sensitivity to eating-disorder behaviors rather than a psychosocial cause of those behaviors. Longitudinal research and controlled trials examining prevention and intervention can clarify and address these clinical concerns. Copyright © 2016 Elsevier Inc. All rights reserved.
Park, Emma C; Waller, Glenn; Gannon, Kenneth
The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.
Full Text Available The research aims to establish the main characteristics of subjects prone to compulsive overeating (experimental group, EG, and the differences between them and the girls who are not prone to any kind of eating disorders (control group, CG. The results of the research are in accordance with the expectations. Girls from the EG exhibit personality characteristics which are signifficantly different from the girls in the CG. These characteristics may be either possible predispositions for development of overeating, or they may already be the consequences of the girls' struggles with overeating and their perception of being overweight. The responses given by the girls from the EG confirm the generaly accepted characteristics of overeating individuals. It can be said that the girls from the ES show the pre-clinical picture of overeating, while some of them have already developed the clinical picture. The results of the research strongly support the view that overeating must be defined as a form of eating disorder just as important as anorexia and bulimia nervosa.
Dominé, F; Dadoumont, C; Bourguignon, J-P
Eating disorders (EDs) are conditions which are becoming more and more widespread among adolescents and they often lead them to seek the opinion of a professional health caregiver, including gynecologists and pediatricians. EDs, and particularly anorexia nervosa (AN), are usually classified as psychological or psychiatric disorders, but they may have major somatic implications and complications as osteoporosis, nutritional deficiencies, cerebral atrophy, cardiac and metabolic disorders. A key issue in the management is prevention or reduction of both the serious somatic consequences and the important mental health consequences (e.g. depression, psychosocial withdrawal, phobia and suicide), integrating different perspectives (psychological or psychiatric - individual and familial -, genetic, nutritional, pediatric, gynecological). Adolescence is a critical period for the onset of EDs though they may also involve younger children. In this case, the consequences on the development (height, weight, puberty) can also be significant. In this review, we will focus on eating disorders in adolescent girls with an emphasis on AN. We describe variations in ED characteristics and their management depending on age at occurrence. A possible ED should be considered by pediatricians consulted about delayed female growth and puberty as well as gynecologists in patients with primary or secondary amenorrhea or infertility. Copyright © 2012 S. Karger AG, Basel.
Jáuregui Lobera, I; Bolaños Ríos, P; Garrido Casals, O
The aim of the study was to analyse the parental bonding profiles in patients with eating disorders (ED), as well as the relationship among the different styles of parenting and some psychological and psychopathological variables. In addition, the association between the perceived parental bonding and different coping strategies was analysed. Perception of parenting styles was analysed in a sample of 70 ED patients. The Parental Bonding Instrument, Self-Esteem Scale of Rosenberg, Coping Strategies Inventory, State-Trait Anxiety Inventory, Beck Depression Inventory and Eating Disorders Inventory-2 were used. Kruskal-Wallis test (comparisons), Spearman correlation coefficients (association among different variables) and χ(2)-test (parental bonding profiles differences) were applied. The stereotyped style among ED patients is low care-high control during the first 16 years, and the same can be said about current styles of the mothers. Between 8.6% and 12.9% of the patients perceive their parents' styles as neglectful. The neglectful parenting is the style mainly involved in the specific ED symptoms as drive for thinness, body dissatisfaction and bulimia. In order to achieve a better balanced parents' role during the treatment, it would be necessary to improve the role of the mothers as caregivers, decreasing their role mainly based on the overprotection. © 2011 Blackwell Publishing.
Resch, Mária; Nagy, Agnes
Since the 1990s numerous international experts have reported about the somatic complications of eating disorders including those having a dental and stomatological nature. Several reports emphasised that deformations in the oral cavity resulting from this grave nutritional disease typical of the young generation could already appear in the early stage and, therefore, dentists are among the first to diagnose them. Dentists are still often unaware of the importance of their role in multidisciplinary treatment. Even if they knew what the disease was about and recognised it on the basis of deformations in the oral cavity in time, their advice that their patients should brush their teeth more often would fail to eliminate the root cause of the problem. Not only the earliest possible treatment of the complications of the bingeing-purging mechanism and the maintenance of oral hygiene are important, but controlling and curing pathological habits with active participation of psychiatrists are also required to ensure full recovery. Due to the multidisciplinary nature of the disease, manifold communication is required. For this reason, publishing the dental ramifications of organic and systemic diseases at dental conferences and in technical journals, as well as providing information about oral complications of eating disorders for general practitioners and specialists are particularly important.
The present article discusses eating disorders. Eating disorders are defined as a serious health threat due to an abnormal relation to food which has become a way of coping with stress. They are also often linked to personality disorders. We have focused mainly on the three most common types of eating disorder – anorexia, bulimia, and compulsive (binge) eating – their recognizable features, the causes that lead to eating disorders, and on preventive measures practiced in ...
Erikson, Martin G; Hansson, Berit; Lundblad, Suzanna
Possible selves are conceptions of our selves in future states. Previous findings indicated that women with anorexia nervosa tended to have more negative possible selves than a control group, even when rating future situations normally regarded in our society as desirable. The present study investigated whether this was a general pattern in women with eating disorders, relating findings on possible selves to depression. Possible selves concerning treatment were also included. Patients with anorexia nervosa (n = 19), bulimia nervosa (n = 29) or an eating disorder not otherwise specified (EDNOS) (n = 18) and a control group (n = 27) rated the valence of five possible selves on Likert's scales. Levels of depression were measured among the patients using the Beck Depression Inventory. The patients rated the valence of the possible selves significantly less positively and more negatively than did the control group. A strong correlation between valence and depression was found in patients with anorexia nervosa and bulimia nervosa. No such correlation was found in patients with EDNOS. Possible selves concerning future treatment were rated even more negatively. The results indicate that, when compared to a non-patient group, eating disorder patients make more negative evaluations of possible selves usually seen as desirable. Depression may be a mediating factor in these evaluations for the anorexia and bulimia patients.
Lunn, Susanne; Poulsen, Stig; Daniel, Sarah I F
The aim of the study was to investigate whether patients with bulimia nervosa (BN) could be subdivided into clinically meaningful groups reflecting the complex patterns of eating disorder symptoms and personality characteristics that face the clinician. Seventy patients diagnosed with BN using the Eating Disorder Examination were assessed with measures of negative affect, attachment patterns, and interpersonal problems. An exploratory hierarchical cluster analysis was performed. The study found two main subtypes differing primarily in terms of symptom severity and level of negative affect, but these subtypes were further subdivided into four clinically relevant subtypes: A dietary restraint/negative affect/high symptomatic group, an emotionally overcontrolled group, a low dietary restraint/emotionally underregulated group, and a high functioning/securely attached group. The study indicates that cluster-analytic studies, including a broad range of instruments measuring eating disorder symptoms as well as negative affect, relational patterns, and other personality characteristics, may contribute to an integration of previously suggested models of subtypes in BN. Copyright © 2012 Elsevier Inc. All rights reserved.
García-Villamisar, Domingo; Dattilo, John; Del Pozo, Araceli
Although perfectionism has long been established as an important risk factor for depressive mood and eating disorders, the mechanisms through which this temperamental predisposition mediates the relationship between depressive mood and eating disorder symptoms are still relatively unclear. In this study we hypothesized that both perfectionism dimensions, self-oriented perfectionism and socially prescribed perfectionism, would mediate the relationship between current symptoms of depression and eating disorders in a non-clinical sample of Spanish undergraduate females. Two hundred sixteen female undergraduate students of the University Complutense of Madrid (Spain) completed the Spanish versions of the Eating Attitudes Test (EAT-40), the Multidimensional Perfectionism Scale (MPS), OBQ-44, and BDI-II and BAI. Results demonstrated the importance of socially prescribed perfectionism in mediation of the relationship between depressive mood and symptoms of eating disorders. Socially prescribed perfectionism mediates the relationship between depressive mood and eating disorder symptoms for female college students.
Salbach, Harriet; Klinkowski, Nora; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Korte, Alexander
Aesthetic sports, especially on a competitive level, are often considered as a risk factor for the development of an eating disorder. A few studies have examined this issue in rhythmic gymnasts, but no reports on body image disturbance exist for these athletes compared to anorectic patients. Fifty elite rhythmic gymnasts (average age 14.8 years) including the German national team, 58 female patients with anorexia nervosa (AN; average age 15.5 years), and 56 high school girls (average age 14.9 years) completed the Eating Disorder Inventory-2 and the Test for Detecting Body Image Distortion in Children and Adolescents (Test zur Erfassung der Körperbildstörung bei Kindern und Jugendlichen). Furthermore, body weight and height, body mass index, presence of amenorrhea and frequency of exercise were surveyed. Body mass index was significantly lower in the elite rhythmic gymnasts than in the high school students, and significantly higher than in the AN patients. Both the elite rhythmic gymnasts and the AN patients were significantly smaller than the high school students. The elite rhythmic gymnasts trained significantly more frequently compared with the AN group and the high school group. Regarding the Eating Disorder Inventory-2 and the Test for Detecting Body Image Distortion in Children and Adolescents, AN patients scored significantly higher on all explored subscales than both the elite rhythmic gymnasts and the high school students. Even though some physical similarities were found for the elite rhythmic gymnasts and the AN patients, contrary to previous studies, no noticeable problems related to attitudinal aspects of eating disorders were detected in the elite rhythmic gymnasts. A mildly distorted body image of the abdomen was identified in elite rhythmic gymnasts, while AN patients expressed a broad body image distortion and students expressed no body image distortion. Our data do not allow us to draw conclusions regarding prevalence rates, long-term effects or
Ung, E K
Anorexia nervosa, bulimia and binge-eating disorder are the three best recognised eating disorders. Eating disorders have been reported to affect some 1 to 3% of adolescent females in the West. Increasing reports from Asia suggest that it is no longer possible to view these illnesses as 'Western' diseases. Eating disorders are the third most common serious medical disorder in female adolescents, after asthma and depression. It poses a tremendous burden for individuals, families and society. Historical and current studies on eating disorders in Singapore are reviewed, and discussed in the light of available regional and worldwide research. Studies on anorexia nervosa and bulimia in Singapore were identified through a MEDLINE search (from 1979). Information from these studies were supplemented with relevant local monographs on eating disorders. Reports of eating disorders have increased over recent years in the local literature. The psychopathology of eating disorders in Singapore is very similar to that described in the Western literature, and in the two main current classification systems. Body dissatisfaction is prevalent among Singaporean Chinese schoolgirls and female undergraduates, with rates not dissimilar to the West. There is a link between 'Westernisation' (based on English being spoken as the main language at home) and body dissatisfaction.
Watts, W. David; Ellis, Anne Marie
Explored relationship between drug and alcohol abuse and eating disorders in female adolescents (n=826). Eating Disorders Risk Scale was adopted and correlated with drug and alcohol use, other forms of deviance, family and peer relationships, and depression. Findings support concept of generalized theory of addictions based on psychosocial,…
Munsch, S; Herpertz, S
Binge eating disorder is one of the most frequent comorbid mental disorders associated with overweight and obesity. Binge eating disorder patients often suffer from other mental disorders and longitudinal studies indicate a continuous weight gain during the long-term course. As in other eating disorders gender is a risk factor, but the proportion of male binge eating disorder patients is surprisingly high.In young women with type 1 diabetes the prevalence of subclinical types of bulimia nervosa is increased. In addition, insulin purging as a characteristic compensatory behavior in young diabetic women poses a considerable problem. In patients with type 1 diabetes, disturbed eating and eating disorders are characterized by insufficient metabolic control and early development of late diabetic sequelae. Patients with type 2 diabetes are often overweight or obese. Binge eating disorder does not occur more frequently in patients with type 2 diabetes compared to healthy persons. However, the comorbidity of binge eating disorder and diabetes type 2 is associated with weight gain and insulin resistance. Especially in young diabetic patients a screening procedure for disturbed eating or eating disorders seems to be necessary. Comorbid patients should be offered psychotherapy.
Binge eating disorder (BED), a chronic condition characterized by eating disorder psychopathology and physical and social disability, represents a significant public health problem. Guided self-help (GSH) treatments for BED appear promising and may be more readily disseminable to mental health care providers, accessible to patients, and…
Raevuori, Anu; Keski-Rahkonen, Anna; Hoek, Hans W.
Purpose of review Research in eating disorders in males has been active lately compared to the past. This review aims to provide an overview of the recently published studies of eating disorders in males. Recent findings Publication of the Diagnostic and Statistical Manual of Mental Disorders, 5th
Smink, Frederique R. E.; van Hoeken, Daphne; Hoek, Hans W.
Purpose of reviewTo review the recent literature about the epidemiology, course, and outcome of eating disorders in accordance with the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).Recent findingsThe residual category eating disorder not otherwise specified'
Wonderlich, Stephen A.; Joiner, Thomas E., Jr.; Keel, Pamela K.; Williamson, Donald A.; Crosby, Ross D.
Decisions about the classification of eating disorders have significant scientific and clinical implications. The eating disorder diagnoses in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) reflect the collective wisdom of experts in the field but are frequently not supported in…
Madsen, Ida Ringsborg; Hørder, Kirsten; Støving, René Klinkby
Eating disorder during pregnancy is associated with a diversity of adverse outcomes and is of potential danger to both mother and child. There is, however, a tendency for remission of the eating disorder during pregnancy with improvement of symptoms such as restrictive dieting, binging and purgin...
Williamson, Donald A.; White, Marney A.; York-Crowe, Emily; Stewart, Tiffany M.
This article presents an integrated cognitive-behavioral theory of eating disorders that is based on hypotheses developed over the past 30 years. The theory is evaluated using a selected review of the eating disorder literature pertaining to cognitive biases, negative emotional reactions, binge eating, compensatory behaviors, and risk factors for…
Wichmann, Susan; Martin, D. R.
Defines different eating disorders, discusses athlete eating problems, and presents the signs physicians should look for that signal the presence of an eating disorder. The article also discusses the tailoring of treatment programs, questions to ask athletes about eating habits, and society's influence on an athlete's eating behavior. (GLR)
In this review we synthesised current literature on the psychopharmacological management of eating disorders (EDs) in children and adolescents (C&As). We focus specifically on anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). The treatment of EDs is determined by physical and ...
Full Text Available Carrie J McAdams,1,2 Whitney Smith1 1University of Texas at Southwestern Medical Center, 2Department of Psychiatry, Texas Health Presbyterian Hospital of Dallas, Dallas, TX, USA Abstract: Eating disorders are complex and serious psychiatric illnesses whose etiology includes psychological, biological, and social factors. Treatment of eating disorders is challenging as there are few evidence-based treatments and limited understanding of the mechanisms that result in sustained recovery. In the last 20 years, we have begun to identify neural pathways that are altered in eating disorders. Consideration of how these pathways may contribute to an eating disorder can provide an understanding of expected responses to treatments. Eating disorder behaviors include restrictive eating, compulsive overeating, and purging behaviors after eating. Eating disorders are associated with changes in many neural systems. In this targeted review, we focus on three cognitive processes associated with neurocircuitry differences in subjects with eating disorders such as reward, decision-making, and social behavior. We briefly examine how each of these systems function in healthy people, using Neurosynth meta-analysis to identify key regions commonly implicated in these circuits. We review the evidence for disruptions of these regions and systems in eating disorders. Finally, we describe psychiatric and psychological treatments that are likely to function by impacting these regions. Keywords: anorexia nervosa, bulimia nervosa, social cognition, reward processing, decision-making
Brownley, Kimberly A.; Berkman, Nancy D.; Peat, Christine M.; Lohr, Kathleen N.; Cullen, Katherine E.; Bann, Carla M.; Bulik, Cynthia M.
Background The best treatment options for binge-eating disorder are unclear. Purpose To summarize evidence about the benefits and harms of psychological and pharmacologic therapies for adults with binge-eating disorder. Data Sources English-language publications in EMBASE, the Cochrane Library, Academic OneFile, CINAHL, and ClinicalTrials.gov through 18 November 2015, and in MEDLINE through 12 May 2016. Study Selection 9 waitlist-controlled psychological trials and 25 placebo-controlled trials that evaluated pharmacologic (n = 19) or combination (n = 6) treatment. All were randomized trials with low or medium risk of bias. Data Extraction 2 reviewers independently extracted trial data, assessed risk of bias, and graded strength of evidence. Data Synthesis Therapist-led cognitive behavioral therapy, lisdexamfetamine, and second-generation antidepressants (SGAs) decreased binge-eating frequency and increased binge-eating abstinence (relative risk, 4.95 [95% CI, 3.06 to 8.00], 2.61 [CI, 2.04 to 3.33], and 1.67 [CI, 1.24 to 2.26], respectively). Lisdexamfetamine (mean difference [MD], −6.50 [CI, −8.82 to −4.18]) and SGAs (MD, −3.84 [CI, −6.55 to −1.13]) reduced binge-eating–related obsessions and compulsions, and SGAs reduced symptoms of depression (MD, −1.97 [CI, −3.67 to −0.28]). Headache, gastrointestinal upset, sleep disturbance, and sympathetic nervous system arousal occurred more frequently with lisdexamfetamine than placebo (relative risk range, 1.63 to 4.28). Other forms of cognitive behavioral therapy and topiramate also increased abstinence and reduced binge-eating frequency and related psychopathology. Topiramate reduced weight and increased sympathetic nervous system arousal, and lisdexamfetamine reduced weight and appetite. Limitations Most study participants were overweight or obese white women aged 20 to 40 years. Many treatments were examined only in single studies. Outcomes were measured inconsistently across trials and rarely
Moriarty, Dick; Moriarty, Mary
Through a review of the literature, this presentation provides information on eating disorders as they relate to sport and fitness and examines the role of all physical and health education teachers, coaches, administrators, and guidance counsellors in either precipitating or preventing anorexia nervosa or bulimia. These professionals are in a…
Boerhout, Cees; van Busschbach, Jooske T.; Wiersma, Durk; Hoek, Hans W.
Eating disorder behaviours can be seen as self-destructive behaviours to a great extent related to inhibited anger expression. However, a treatment protocol targeted at anger and aggression in these disorders is lacking. This paper describes a psychomotor therapy (PMT) model as a body-oriented
Vallée, Denis; Legrée, Isabelle
With eating disorders, family therapies are concerned with how the family relationships work. The aim is to develop sufficient relational flexibility in order that each family member can find his or her place and develop their autonomy, without threatening the family balance.
Nagel, K. L.; Jones, Karen H.
Reviews sociocultural, socioeconomic, and sex-related factors which contribute to development of eating disorders. Recommends that professionals help adolescents resist societal pressure to conform to unrealistic standards of appearance and provide guidance on nutrition, realistic body ideals, and achievement of self-esteem, self-efficacy,…
Full Text Available Concerns about body shape and weight are core diagnostic criteria for eating disorders although intensity varies between patients. Few studies have focused on the clinical differences relative to the intensity of these concerns. Nonetheless, they might have a prognostic value. This study was aimed at identifying the characteristics associated with marked body shape concerns in patients with an eating disorder. Data was collected from a systematic and standardized clinical assessment of outpatients seeking treatment in our department for eating disorders. Only female patients, suffering from anorexia nervosa or bulimia nervosa, and with "no / mild" or "marked" body shape concerns according to the Body Shape Questionnaire, were included for the present study. We focused on sociodemographic characteristics, eating disorder characteristics, axis 1 disorders, types of attachment, self-esteem and dissociation. A multiple logistic regression was performed to identify factors related to "marked" body shape concerns. In our sample (123 participants, with a mean age of 24.3 years [range 16-61], 56.9% had marked concerns with body shape. Marked body shape concerns were associated with a major depressive episode (OR = 100.3, the use of laxatives (OR = 49.8, a high score on the item "body dissatisfaction" of the Eating Disorders Inventory scale (OR = 1.7, a higher minimum body mass index (OR = 1.73, and a high score on the item "loss of control over behavior, thoughts and emotions" from the dissociation questionnaire (OR = 10.74. These results are consistent with previous studies, and highlight the importance of denial.
Full Text Available Background: Socio-physical anxiety, body image, and self esteem are variables that play an important role on eating disorders. The purpose of this research was the role of socio-physical anxiety, body image and self esteem in prediction of the eating disorders in sportswomen.Materials and Method: 181 of aerobic and physical readiness sportswomen were selected by clustered sampling method and filled the questionnaire containing eating disorder, socio-physical anxiety, body image concern and self esteem scales. Results: According to this research, there was meaningful correlation between social physical anxiety (r=-0.326, body image concern (r=0.466 and self-esteem (r=0.349 with eating disorders and these variables were explained the 0.27 variance in eating disorders. Conclusion: Results are corresponding with previous studies and have important implications in attention to the predicting variables of eating disorders in athletes’ women
Zerwas, Stephanie; Larsen, Janne Tidselbak; Petersen, Liselotte
OBJECTIVES: Identifying factors associated with risk for eating disorders is important for clarifying etiology and for enhancing early detection of eating disorders in primary care. We hypothesized that autoimmune and autoinflammatory diseases would be associated with eating disorders in children...... and adolescents and that family history of these illnesses would be associated with eating disorders in probands. METHODS: In this large, nationwide, population-based cohort study of all children and adolescents born in Denmark between 1989 and 2006 and managed until 2012, Danish medical registers captured all...... inpatient and outpatient diagnoses of eating disorders and autoimmune and autoinflammatory diseases. The study population included 930 977 individuals (48.7% girls). Cox proportional hazards regression models and logistic regression were applied to evaluate associations. RESULTS: We found significantly...
Davidsen, Annika Helgadóttir; Poulsen, Stig; Lindschou, Jane
Objective: To investigate the effect of client feedback in group psychotherapy on attendance and treatment outcome for patients with eating disorders. Method: We conducted a randomized clinical trial with central randomization stratified for diagnosis and treatment type according to a computer...... outcome was rate of attendance to treatment sessions; the secondary outcome was severity of eating disorder symptoms measured with the Eating Disorder Examination interview. Exploratory outcomes were psychological distress measured with the Symptom Checklist-90-R and the Outcome Rating Scale, social......-generated allocation sequence concealed to the investigators. One-hundred and 59 adult participants, diagnosed with bulimia nervosa, binge eating disorder, or eating disorder not otherwise specified according to DSM-IV, were included. Eighty participants were allocated to the experimental group, and 79 participants...
Harshbarger, J L; Ahlers-Schmidt, C R; Atif, M; Allred, E; Carroll, M; Hauser, R
Twenty years ago, Price published a survey identifying knowledge deficits of school counselors regarding eating disorders. Our study surveys current school counselors to determine whether knowledge has increased and determine the availability of school-based prevention programming. School counselors from a single metropolitan area were surveyed prior to a mandatory in-service on eating disorders. Of the 109 respondents, 55% felt eating disorders were a problem in their school. Very few felt "very competent" identifying (6%) or helping (2%) students with eating disorders. Today's school counselors were more likely to know a symptom of anorexia nervosa (AN) is missing at least three consecutive menstrual cycles and malnutrition is not a common cause of death for bulimia nervosa (BN). While knowledge of AN and BN appear to have increased, school counselors still lack some basic understanding and report very low confidence in identifying and helping students with eating disorders.
Asami, Tomokuni; Yanase, Maya; Nomura, Toshiaki; Okubo, Yoshiro
The number of offenders with eating disorders in women's prisons in Japan has grown annually over the last 15 years. Women's prisons have experienced significant difficulties in the management of patients with eating disorders who have body-critical complications arising from low body weight, in addition to behavioral problems. Patients in Japan's 185 correctional facilities who display high refractoriness or who present a physical risk are transferred to the Hachioji medical prison, a national specialty hospital operated by the Ministry of Justice. The medical prison must manage any psychosomatic problems necessary for the safety of inmates regardless of a patient's wishes. The most common conviction resulting in imprisonment of women with eating disorders was shoplifting ( n = 44; 63%), with the second most common being drug-offenses ( n = 17; 24%). While shoplifting is of concern in relation to eating disorders, a causal relationship remains unclear. Most patients in the shoplifting group did not have histories of antisocial and/or impulsive behaviors such as drug abuse, sexual deviation, self-injury, or other criminal activity. Instead, shoplifting appears to be an obsessive-compulsive behavior deeply rooted in the psychopathology of severe eating disorder patients. Patients in this group tended to have histories of relatively high education and steady employment, although most also had histories of prolonged eating disorders and unstable treatment. Although adherence to treatment was poor among patients with eating disorders in the medical prison, body weight and behavioral problems improved following treatment in the special compulsory environment, without severe sequelae or patient death. The Ministry of Justice recently established another specialized ward for the care for female patients with eating disorders. If greater emphasis is placed on early-stage, protective, medical treatment, the number of patients with eating disorders in prisons may
Full Text Available Objective: The aim of this study was to compare some psychological and psychopathological variables usually associated with different types of patients with eating disorders (ED. A total of 22 variables (psychological, psychopathological and specifically related to TCA were analyzed in three groups of patients with anorexia nervosa (AN, bulimia nervosa (BN and eating disorders not otherwise specified (EDNOS. Method: The sample consisted of 76 patients diagnosed with ED (mean age 20.13 ± 6.28 years; 69 women and 7 men. The following questionnaires were administered: Rosenberg's Self-Esteem Scale (SES, Symptom Checklist-90-Revised (SCL-90-R, Beck's Depression Inventory (BDI, State-Trait Anxiety Inventory (STAI, Body Shape Questionnaire (BSQ, Body Appreciation Scale (BAS, Eating Disorder Inventory-2 (EDI-2 and Body Image Quality of Life Inventory (BIQLI-SP. Results: Generally no significant differences between groups, except for the variables related to the BSQ and EDI-2 questionnaires, were found. The study of the correlations among the different variables specifically related to eating disorders and others, showed differences between groups. Conclusions: The present study shows few differences with respect to psychopathological symptoms among the different types of ED. Bearing in mind future studies, it would be interesting to use a bigger sample size, to include more men, and to distinguish between restricted/purging types of ED.
Fitzsimmons-Craft, Ellen E; Ciao, Anna C; Accurso, Erin C; Pisetsky, Emily M; Peterson, Carol B; Byrne, Catherine E; Le Grange, Daniel
This study investigated the importance of the distinction between objective (OBE) and subjective binge eating (SBE) among 80 treatment-seeking adolescents with bulimia nervosa. We explored relationships among OBEs, SBEs, eating disorder (ED) symptomatology, depression, and self-esteem using two approaches. Group comparisons showed that OBE and SBE groups did not differ on ED symptoms or self-esteem; however, the SBE group had significantly greater depression. Examining continuous variables, OBEs (not SBEs) accounted for significant unique variance in global ED pathology, vomiting, and self-esteem. SBEs (not OBEs) accounted for significant unique variance in restraint and depression. Both OBEs and SBEs accounted for significant unique variance in eating concern; neither accounted for unique variance in weight/shape concern, laxative use, diuretic use, or driven exercise. Loss of control, rather than amount of food, may be most important in defining binge eating. Additionally, OBEs may indicate broader ED pathology, while SBEs may indicate restrictive/depressive symptomatology. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association.
Zerwas, Stephanie; Larsen, Janne Tidselbak; Petersen, Liselotte; Thornton, Laura M; Quaranta, Michela; Koch, Susanne Vinkel; Pisetsky, David; Mortensen, Preben Bo; Bulik, Cynthia M
Identifying factors associated with risk for eating disorders is important for clarifying etiology and for enhancing early detection of eating disorders in primary care. We hypothesized that autoimmune and autoinflammatory diseases would be associated with eating disorders in children and adolescents and that family history of these illnesses would be associated with eating disorders in probands. In this large, nationwide, population-based cohort study of all children and adolescents born in Denmark between 1989 and 2006 and managed until 2012, Danish medical registers captured all inpatient and outpatient diagnoses of eating disorders and autoimmune and autoinflammatory diseases. The study population included 930 977 individuals (48.7% girls). Cox proportional hazards regression models and logistic regression were applied to evaluate associations. We found significantly higher hazards of eating disorders for children and adolescents with autoimmune or autoinflammatory diseases: 36% higher hazard for anorexia nervosa, 73% for bulimia nervosa, and 72% for an eating disorder not otherwise specified. The association was particularly strong in boys. Parental autoimmune or autoinflammatory disease history was associated with significantly increased odds for anorexia nervosa (odds ratio [OR] = 1.13, confidence interval [CI] = 1.01-1.25), bulimia nervosa (OR = 1.29; CI = 1.08-1.55) and for an eating disorder not otherwise specified (OR = 1.27; CI = 1.13-1.44). Autoimmune and autoinflammatory diseases are associated with increased risk for eating disorders. Ultimately, understanding the role of immune system disturbance for the etiology and pathogenesis of eating disorders could point toward novel treatment targets. Copyright © 2017 by the American Academy of Pediatrics.
Giel, Katrin Elisabeth; Hermann-Werner, Anne; Mayer, Jochen; Diehl, Katharina; Schneider, Sven; Thiel, Ansgar; Zipfel, Stephan
We aimed to investigate eating disorder pathology in German elite adolescent athletes. Evidence suggests that eating disorder pathology is more common in adult elite sports, especially in female athletes and in sports emphasizing leanness. There is a scarcity of studies in elite adolescent athletes who are in a vulnerable developmental stage and are affected by general as well as sport-specific risk factors. Our data was derived from the German Young Olympic Athletes' Lifestyle and Health Management Study (GOAL) which conducted a survey in 1138 elite adolescent athletes. In this sample, we assessed body weight, weight control behavior, body acceptance and screened overall for core symptoms of eating disorders, depression and anxiety. We performed a tree analysis to identify high risk groups for eating disorder pathology. High risk groups comprised (a) athletes competing in weight dependent sports, and among athletes competing in disciplines other than weight dependent sports (b) athletes who are high on negative affectivity, (c) female athletes and (d) male athletes competing in endurance, technical or power sports. Athletes competing in weight dependent disciplines reported wide spread use of compensatory behaviors to influence body weight. Athletes reporting eating disorder pathology showed higher levels of depression and anxiety than athletes without eating disorder pathology. Increased psychosocial burden in athletes with eating disorder pathology suggests that eating disorder symptoms should not be accepted as an unproblematic and functional part of elite sports. The prevention and management of eating disorder pathology is especially important in weight dependent sports. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:553-562). © 2016 Wiley Periodicals, Inc.
Compare, Angelo; Calugi, Simona; Marchesini, Giulio; Shonin, Edo; Grossi, Enzo; Molinari, Enrico; Dalle Grave, Riccardo
To test the effect on psychopathology and quality of life of Emotionally Focused Therapy (EFT), Dietary Counseling (DC), and Combined Treatment (CT) in treatment-seeking patients with Binge Eating Disorder (BED) and obesity. Utilizing an observational study design, 189 obese adult patients with BED were treated by manualized therapy protocols. An independent assessment of health-related quality of life (Obesity-Related Well-Being questionnaire - ORWELL-97), attitudes toward eating (Eating Inventory - EI), binge eating (Binge Eating Scale - BES) and body uneasiness (Body Uneasiness Test - BUT) was performed at baseline, end-of-treatment, and six-month follow-up. These data are the secondary outcomes of a previously published treatment study. A higher dropout rate was observed in the DC compared to the EFT and CT groups, while body weight decreased significantly in all three groups. Pre-post scores on the BES, BUT Global Severity Index, and EI Hunger subscale significantly decreased in the CT and EFT groups (but not the DC group). At six-month follow-up, 71% of participants in CT and 46% of participants in EFT had a BES score below the threshold of attention for BED (≤16), whereas no participants in the DC group reached this target. Finally the ORWELL-97 score decreased significantly in all groups, but significantly more so in the CT and EFT groups. Results support the utility of combining EFT and DC in the treatment of patients with BED and obesity, emphasizing the usefulness of techniques focused on cognitive emotional processing for changing eating disorder psychopathology and quality of life. Copyright © 2013 Elsevier Ltd. All rights reserved.
Full Text Available Studies on Emotional Intelligence (EI have demonstrated the concept’s potential in accounting for a broad range of health-related outcomes. Preliminary evidence associates measures of EI with disordered eating and other related behaviors. This study proposed a mediation effect of perceived control in the above association. We hypothesized that (a EI will positively associate with perceived control and (b perceived control will associate positively with Anorexia and negatively with Bulimia symptomatology. One hundred and thirty young adults residing in Israel filled out measures assessing Anorexia (drive for thinness, Bulimia, perceived control, and EI (two measures. The results lent only partial support to the hypotheses: EI showed a nonlinear association with control, which in turn showed nonlinear association with Anorexia scores, and contrary to our hypothesis, positive association with Bulimia scores. A Sobel test supported the mediation models for both eating disorder measures. The results are discussed and future research is proposed to further examine this hypothesized mechanism.
Smink, Frédérique R E; van Hoeken, Daphne; Oldehinkel, Albertine J; Hoek, Hans W
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a considerably revised eating disorder section. The aim of this study was to establish the prevalence and severity of eating disorders based on the new DSM-5 criteria in a community cohort of adolescents. This study is part of TRAILS (TRacking Adolescents' Individual Lives Survey), a Dutch cohort study on mental health and social development from preadolescence into young adulthood. At baseline, the participants (n = 2,230) were about 11 years old. Body mass index was measured at all four assessment waves. At age 19, the Composite International Diagnostic Interview was administered to 1,584 of the participants. A two-stage screening approach was used to estimate the prevalence of DSM-5 eating disorders. Adolescents at high risk for eating disorders (n = 312) were selected for an additional interview administered by eating disorder experts. Of the high-risk group n = 296 (95%) could be interviewed. Among the women, the lifetime prevalence of DSM-5 anorexia nervosa was 1.7%, of bulimia nervosa 0.8% and of binge eating disorder 2.3%. Eating disorders were relatively rare among the men. The severity of most cases was mild to moderate and detection and treatment rates depended on the level of severity. The most common DSM-5 eating disorder diagnoses in adolescents in the community are anorexia nervosa and binge eating disorder. Severity ratings for eating disorders seem valid in terms of both the distribution in the community and the correlation with detection and treatment by health care services. © 2014 Wiley Periodicals, Inc.
Halvorsen, Tori Flaatten; Rosvold, Elin Olaug; Rydså, Birgit Johanne; Skarbø, Tove; Haavet, Ole Rikard
An eating disorder is a complex disease in which the patient subjects his or her body to the various eating disorder symptoms in the absence of other ways of dealing with everyday life. There are seven symptoms of an eating disorder that generally appear in different combinations from one period to another in one and the same patient. Feelings of shame may cause information on symptoms to be withheld. Patients aged 18 and above with serious eating disorders responded anonymously to a questionnaire before entering treatment in two specialist departments. The main focus was on whether the patient had talked with a general practitioner (GP) about relevant eating disorder symptoms and ailments that could be related to the eating disorder. Altogether 114 patients participated (of which three were men). A total of 91 (80%) had discussed the eating disorder with their GP during the past year. Of these, 67% of those who had reduced their food intake over the past year had discussed this with their GP. Altogether 68% of those who had vomited and 33% of those who had over-exercised had communicated this. None of the respondents had revealed their use of diuretic or weight-loss drugs to their GP. 85% of respondents stated that the GP must ask specifically about each symptom of an eating disorder in order to reveal these. At least half had discussed the association between current ailments and the eating disorder. A total of 49% had been weighed. In order to be able to establish the best possible basis for a medical assessment, the GP should ask specifically about each symptom of an eating disorder.
Murray, Stuart B.; Krug, Isabel; McLean, Siân A.
Abstract Social media has been associated with body dissatisfaction and eating disorder symptoms among young women and adolescent girls. However, despite notable evidence of susceptibility to body image pressures, it remains unknown whether these associations generalize to sexual minority men. A nationwide sample of 2,733 sexual minority men completed an online survey advertised to Australian and New Zealand users of a popular dating app. Participants answered questions about how frequently they used 11 different social media platforms in addition to questions about their dating app use, body image, eating disorder symptoms, and anabolic steroids. Facebook, Youtube, Instagram, and Snapchat were the most frequently used social media platforms. A pattern of small-sized and positive associations emerged between social media use and body dissatisfaction, eating disorder symptoms, and thoughts about using anabolic steroids. Facebook, Instagram, and Snapchat evidenced the strongest associations. The associations of social media use with both muscularity dissatisfaction and eating disorder symptoms were stronger for image-centric social media platforms (e.g., Instagram) than nonimage-centric platforms (e.g., Wordpress); no differences were observed for body fat dissatisfaction, height dissatisfaction, or thoughts about using anabolic steroids. Previously documented associations of social media use with body dissatisfaction and related variables among women and girls appear to generalize to sexual minority men. Social media platforms that more centrally involve imagery may be of greater concern than nonimage-centric platforms. Additional research with sexual minority men is needed to elucidate the distinctions between adaptive and maladaptive social media use in the context of body dissatisfaction, eating disorders, and anabolic steroid use. PMID:29363993
Uehara, Miho; Sakakibara, Hisataka
The purpose of the present study was to investigate the prevalence of eating disorders and their relevant factors in Japanese women. Anonymous self-administered questionnaire surveys of 3023 working women aged 20-39 were conducted during health checkups in Tokyo, Nagoya, Osaka, and Fukuoka in 2012. Eating disorders were assessed using Eating Attitudes Test-26 (EAT-26). The factors related to EAT-26 scores ≥20 were analyzed by multiple logistic regression. The prevalences of eating disorders among the participants with EAT-26 scores ≥20 were 2.4% [95% confidence interval (95% CI): 1.8-2.9%] of all the participating women aged 20-39, 3.4% (95% CI: 2.5%-4.3%) of women in their 20s, and 1.2% (95% CI: 0.6%-1.8%) of women in their 30s. Logistic regression analysis showed that EAT-26 scores of ≥20 were associated with the following variables: perceived ideal BMI ≤17.5 kg/m(2) (OR: 4.55, 95% CI: 2.08-9.93), change in body weight in the previous six months (OR: 2.83, 95% CI: 1.61-4.95), being 20-29 years of age (OR: 2.64, 95% CI: 1.42-4.89), and the perception of being fat (OR=2.54, 95% CI: 1.24-5.18). The prevalence of eating disorders with EAT-26 scores ≥20 was 2.4% (95% CI: 1.8%-2.9%) among Japanese working women aged 20-39. EAT-26 scores ≥20 were most closely associated with a perceived ideal BMI of ≤17.5 kg/m(2). Eating disorders may be more prevalent among women who want to lose weight to achieve a BMI of ≤17.5 kg/m(2), and these women should be carefully monitored.
Griffiths, Scott; Murray, Stuart B; Krug, Isabel; McLean, Siân A
Social media has been associated with body dissatisfaction and eating disorder symptoms among young women and adolescent girls. However, despite notable evidence of susceptibility to body image pressures, it remains unknown whether these associations generalize to sexual minority men. A nationwide sample of 2,733 sexual minority men completed an online survey advertised to Australian and New Zealand users of a popular dating app. Participants answered questions about how frequently they used 11 different social media platforms in addition to questions about their dating app use, body image, eating disorder symptoms, and anabolic steroids. Facebook, Youtube, Instagram, and Snapchat were the most frequently used social media platforms. A pattern of small-sized and positive associations emerged between social media use and body dissatisfaction, eating disorder symptoms, and thoughts about using anabolic steroids. Facebook, Instagram, and Snapchat evidenced the strongest associations. The associations of social media use with both muscularity dissatisfaction and eating disorder symptoms were stronger for image-centric social media platforms (e.g., Instagram) than nonimage-centric platforms (e.g., Wordpress); no differences were observed for body fat dissatisfaction, height dissatisfaction, or thoughts about using anabolic steroids. Previously documented associations of social media use with body dissatisfaction and related variables among women and girls appear to generalize to sexual minority men. Social media platforms that more centrally involve imagery may be of greater concern than nonimage-centric platforms. Additional research with sexual minority men is needed to elucidate the distinctions between adaptive and maladaptive social media use in the context of body dissatisfaction, eating disorders, and anabolic steroid use.
Sun, Bomin; Liu, Wei
EATING DISORDERS (EDS) ARE A GROUP OF SEVERELY IMPAIRED EATING BEHAVIORS, WHICH INCLUDE THREE SUBGROUPS: anorexia nervosa (AN), bulimia nervosa (BN), and ED not otherwise specified (EDNOS). The precise mechanism of EDs is still unclear and the disorders cause remarkable agony for the patients and their families. Although there are many available treatment methods for EDs today, such as family therapy, cognitive behavioral therapy, medication, psychotherapy, and so on, almost half of the patients are refractory to all current medical treatment and never fully recover. For treatment-refractory EDs, stereotactic surgery may be an alternative therapy. This review discusses the history of stereotactic surgery, the modern procedures, and the mostly used targets of stereotactic surgery in EDs. In spite of the limited application of stereotactic surgery in ED nowadays, stereotactic lesion and deep brain stimulation (DBS) are promising treatments with the development of modern functional imaging techniques and the increasing understanding of its mechanism in the future.
Blodgett Salafia, Elizabeth H; Jones, Maegan E; Haugen, Emily C; Schaefer, Mallary K
In this study, we examined perceptions regarding the causes of eating disorders, both among those with eating disorders as well as those without. By understanding the differences in perceived causes between the two groups, better educational programs for lay people and those suffering from eating disorders can be developed. This study used open-ended questions to assess the beliefs of 57 individuals with self-reported eating disorders and 220 without. Participants responded to the questions, "What do you think was (were) the cause(s) of your eating disorder?" and "What do you think is (are) the cause(s) of eating disorders?". A list of possible codes for the causes of eating disorders was created based on a thorough review of the literature. A manually-generated set of eight codes was then created from individuals' actual responses. Frequencies and chi square analyses demonstrated differences in rates of endorsement between those with eating disorders and those without. Participants with eating disorders most frequently endorsed psychological/emotional and social problems, with genetics/biology and media/culture ideals least endorsed. Participants without eating disorders most frequently endorsed psychological/emotional problems and media/culture ideals, with traumatic life events and sports/health least endorsed. There was a difference between groups in the endorsement of the media as a cause of eating disorders, suggesting that those without eating disorders may overly attribute the media as the main cause while those with eating disorders may not be fully aware of the media's impact. Additionally, while both groups highly endorsed psychological/emotional problems, there was a noticeable stigma about eating disorders among those without eating disorders. There were noteworthy differences between samples; such differences suggest that there is a need for more education on the topic of eating disorders. Furthermore, despite empirical support for the effects of
Esther Quirós Abajo
Full Text Available Eating Disorders are an important health problem of our society because of their rising incidence in the last years, as well as their high cost in terms of Public Health. Nowadays the best option to face this problem is through prevention. The objective of the present work is to evaluate if a Web nursing intervention based on Cognitive-Behavioural Therapy can prevent Eating Disorders by reducing risk factors in 15 to 18 years old women.Methodology: It is a randomized clinical trial in which the experimental group will receive the Web nursing intervention and the control group will not receive any kind of preventive intervention related to Eating Disorders. The study will be developed in six Secondary Education Institutes of the areas 9 and 10 of Madrid Community. Women at risk will be selected by the Body Shape Questionnaire (BSQ. Risk factors such as body image dissatisfaction, eating and depressive symptoms will be evaluated. Measurements will be, besides BSQ, the Body Attitudes Test (BAT, the Eating Disorders Inventory (EDI, the Eating Attitudes Test (EAT and the Beck Depression Inventory (BDI.
Raevuori, Anu; Linna, Milla S; Keski-Rahkonen, Anna
The objective of this descriptive review is to summarize the current scientific evidence on various prenatal and perinatal exposures affecting later development of eating disorders among offspring. Studies were searched from PubMed database with the following keywords: eating disorders and disordered eating and anorexia nervosa and bulimia nervosa and binge eating disorder and prenatal exposure delayed effects and maternal exposure and perinatology. A comprehensive manual search, including search from the reference list of included articles, was also performed. The attributable risk for prenatal and perinatal factors in anorexia nervosa (AN) is 3.6%. Numerous prenatal and perinatal factors have been associated with offspring AN, but only prematurity has been replicated in different samples. The risk of bulimia nervosa (BN) in offspring has attracted less study, and despite varying positive associations, there are no replicated findings. Higher prenatal testosterone may protect against the development of a range of disordered eating symptoms, although studies are not consistent. Evidence in support of an effect of prenatal and perinatal factors on eating disorders or disordered eating in offspring is conflicting. If present, the overall effect appears to be relatively small, and it is likely that the early risk factors operate in conjunction with other biological, genetic, and/or environmental risk factors to bring on eating pathology. Genetically sensitive designs, such as sibling and twin studies, are needed to disentangle the different types of risk factors and ensure that prenatal/perinatal effects are "causal" rather than indications of genetic risk. © 2014 Wiley Periodicals, Inc.
Full Text Available Objective. Despite evidence from case series, the comorbidity of eating disorders (EDs with schizophrenia is poorly understood. This review aimed to assess the epidemiological and clinical characteristics of EDs in schizophrenia patients and to examine whether the management of EDs can be improved. Methods. A qualitative review of the published literature was performed using the following terms: “schizophrenia” in association with “eating disorders,” “anorexia nervosa,” “bulimia nervosa,” “binge eating disorder,” or “night eating syndrome.” Results. According to our literature review, there is a high prevalence of comorbidity between schizophrenia and EDs. EDs may occur together with or independent of psychotic symptoms in these patients. Binge eating disorders and night eating syndromes are frequently found in patients with schizophrenia, with a prevalence of approximately 10%. Anorexia nervosa seems to affect between 1 and 4% of schizophrenia patients. Psychopathological and neurobiological mechanisms, including effects of antipsychotic drugs, should be more extensively explored. Conclusions. The comorbidity of EDs in schizophrenia remains relatively unexplored. The clearest message of this review is the importance of screening for and assessment of comorbid EDs in schizophrenia patients. The management of EDs in schizophrenia requires a multidisciplinary approach to attain maximized health outcomes. For clinical practice, we propose some recommendations regarding patient-centered care.
Day, Jemma; Ternouth, Andrew; Collier, David A
The eating disorders anorexia and bulimia nervosa have traditionally been regarded as entirely separate from obesity. Eating disorders have been regarded as Western culture-bound syndromes, arising in societies with excessive emphasis on weight, shape and appearance, and best treated by psychological therapies, in particular cognitive behavioural therapy or family-based interventions. In contrast, obesity has been considered a medical illness with metabolic and genetic origins, and thought to be best treated by mainstream medicine, involving dietary, drug or surgical treatment. We believe that this polarisation is fundamentally flawed, and research and treatment of both types of disorder would be better served by greater appreciation of the psychosocial components of obesity and the biological and genetic components of eating disorders. There are similarities in phenotype (such as excessive attempts at weight control, binge eating behaviours) and in risk factors (such as low self-esteem, external locus of control, childhood abuse and neglect, dieting, media exposure, body image dissatisfaction, weight-related teasing and shared susceptibility genes). One example of shared genetic risk is the brain-derived neurotrophic factor (BNDF) gene, in which the valine allele of the Val66Met amino acid polymorphism predisposes to obesity, whereas the methionine allele predisposes to eating disorders. Thus the evidence suggests that these disorders will have both shared and distinct susceptibility factors; some will predispose to both types of disorder, some will push in opposite directions, and some will separate them.
Gearhardt, Ashley N.; White, Marney A.; Potenza, Marc N.
Binge eating disorder (BED) shares many characteristics with addictive behaviors (e.g., diminished control, continued use despite negative consequences), and a body of scientific literature is building to support addiction conceptualizations of problematic eating. Despite similarities, BED and “food addiction” may represent unique yet overlapping conditions. Although the exploration of food addiction is relatively new, understanding the relationship between food addiction and BED may be informative in understanding the mechanisms underlying the development and maintenance of problematic eating. In the following paper, we 1) examine the theoretical similarities and differences between BED and addiction, 2) review recent empirical evidence that speak to the relationship between BED and food addiction and 3) discuss the implications of associations between BED and food addiction with respect to clinical interventions. PMID:21999695
Watson, Hunna J; Street, Helen; Raykos, Bronwyn C; Byrne, Susan M; Fursland, Anthea; Nathan, Paula R
The aim of this study was to develop and validate a self-report measure of Conditional Goal Setting (CGS) for use among individuals with eating disorders, the Conditional Goal Setting in Eating Disorders Scale (CGS-EDS). The CGS-EDS assesses the degree to which an individual believes that the achievement of happiness is contingent upon the attainment of body shape and weight goals. Women with a DSM-IV diagnosed eating disorder consecutively referred to a specialist outpatient clinic (N=238) completed the CGS-EDS and self-report measures of theoretically related constructs. Exploratory factor analysis indicated a one-factor solution, which accounted for 65% of the variance. The CGS-EDS correlated positively with theoretically related measures of overvaluation of shape and weight, concern with shape and weight, dichotomous thinking, and depression. The alpha reliability of the scale was .92. The CGS-EDS is a valid and reliable measure of CGS in eating disorders and is relevant to cognitive and behavioral models of maintenance and intervention. Copyright 2009 Elsevier Ltd. All rights reserved.
Eating disorders have become increasingly prevalent in North America. Anorexia nervosa, bulimia nervosa, and binge eating disorder were previously thought to solely affect Caucasian women. However, contemporary research has studied the occurrence of this phenomenon in ethnic minority women, such as Latinas. This article presents a critical review of 12 quantitative, prospective psychological research studies from the past 17 years. The authors in the reviewed literature identified bodily dissatisfaction, environmental influences, and acculturation as significant risk factors in the development of eating disorders in Hispanic girls and women. The methodology and empirical findings from these studies are discussed, and suggestions for future research and culturally sensitive clinical treatment are considered.
Szabó, Kornélia; Túry, Ferenc
In the current study we reviewed the literature on studies exploring the magazine reading frequency, written and pictorial contents appearing in magazines and their connection to eating disorders. Reading different fashion and fitness magazines has effect on readers through several indirect and direct factors and through trustable and false information. They affect readers' body satisfaction, self-esteem, eating habits and more generally their health behavior. Different theories have been explained to account for these associations and several other studies examined empirically the connection between the frequency of magazine reading and eating disorders, as well as the symptoms leading to eating disorders. We analyzed and summarized articles between 1975 and 2009 from online databases. We used the following sources: Science Direct (http://www.sciencedirect.com/), Springer-Verlag GmbH (http://www.springerlink.com/) and SAGE Publications Ltd (http://online.sagepub. com/). The pictorial and written magazine contents were associated with the development and maintenance of eating disorders or with symptoms that might lead to eating disorders. The publications compared to previous years featured an increased number of advertisements for unhealthy foods, for unhealthy radical diet plans and exercise programs. Furthermore the magazines contained conflicting messages about nutrition, body functions and eating disorders. Written and pictorial magazine contents, messages might increase the risk for development of eating disorders, especially in vulnerable individuals.
Haynos, Ann F; Roberto, Christina A; Attia, Evelyn
There is growing interest in the role of emotion regulation in anorexia nervosa (AN). Although anxiety is also hypothesized to impact symptoms of AN, little is known about how emotion regulation, anxiety, and eating disorder symptoms interact in AN. In this study, we examined the associations between emotion regulation, anxiety, and eating disorder symptom severity in AN. Questionnaires and interviews assessing emotion regulation difficulties, anxiety, eating disorder symptoms, and eating disorder-related clinical impairment were collected from group of underweight individuals with AN (n=59) at admission to inpatient treatment. Hierarchical linear regressions were used to examine the associations of emotion regulation difficulties, anxiety, and the interaction of these constructs with eating disorder symptoms and eating disorder-related clinical impairment. Emotion regulation difficulties were significantly positively associated with eating disorder symptoms and related clinical impairment only when anxiety levels were low and anxiety was significantly positively associated with eating disorder symptoms and related clinical impairment only when emotion regulation problems were not elevated. This study adds to a growing literature suggesting that emotion regulation deficits are associated with eating disorder symptoms in AN. Certain individuals with AN may especially benefit from a focus on developing emotion regulation skills in the acute stages of illness. Copyright © 2015 Elsevier Inc. All rights reserved.
Full Text Available Ignacio Jáuregui-Lobera,1 Patricia Bolaños-Ríos,2 Inmaculada Ruiz-Prieto21Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain; 2Behavioral Sciences Institute, Seville, SpainPurpose: The aim of this study was to analyze the relationships among thought–shape fusion (TSF, specific instruments to assess body image disturbances, and body image quality of life in eating disorder patients in order to improve the understanding of the links between body image concerns and a specific bias consisting of beliefs about the consequences of thinking about forbidden foods.Patients and methods: The final sample included 76 eating disorder patients (mean age 20.13 ± 2.28 years; 59 women and seven men. After having obtained informed consent, the following questionnaires were administered: Body Appreciation Scale (BAS, Body Image Quality of Life Inventory (BIQLI-SP, Body Shape Questionnaire (BSQ, Eating Disorders Inventory-2 (EDI-2, State-Trait Anxiety Inventory (STAI, Symptom Checklist-90-Revised (SCL-90-R and Thought-Shape Fusion Questionnaire (TSF-Q.Results: Significant correlations were found between TSF-Q and body image-related variables. Those with higher scores in TSF showed higher scores in the BSQ (P < 0.0001, Eating Disorder Inventory – Drive for Thinness (EDI-DT (P < 0.0001, and Eating Disorder Inventory – Body Dissatisfaction (EDI-BD (P < 0.0001. The same patients showed lower scores in the BAS (P < 0.0001. With respect to the psychopathological variables, patients with high TSF obtained higher scores in all SCL-90-R subscales as well as in the STAI.Conclusion: The current study shows the interrelations among different body image-related variables, TSF, and body image quality of life.Keywords: cognitive distortions, quality of life, body appreciation, psychopathology, anorexia nervosa, bulimia nervosa
Boisvert, Jennifer A; Harrell, W Andrew
There is currently a gap in our knowledge of how eating disorder symptomatology is impacted by spirituality and religiosity. To date, studies examining the role of ethnicity in women's self-reported levels of eating disorder symptomatology have neglected the roles of spirituality and religiosity. This study addresses this gap in the literature by investigating ethnicity, spirituality, religiosity, body shame, body mass index (BMI) and age in relation to eating disorder symptomatology in women. A representative non-clinical sample of ethnically diverse Canadian women (N = 591) was surveyed. Younger women, particularly those with higher body shame, BMI and lower spirituality, reported more eating disorder symptomatology. Hispanic and Asian women had higher body shame and lower BMI compared to white women. Spirituality was more strongly related to eating disorder symptomatology than religiosity. This is the first study identifying interactive relationships between ethnicity, spirituality, body shame, BMI and age on eating disorder symptomatology in women. Particularly significant is that higher spirituality was related to a lower level of eating disorder symptomatology. These findings have important implications for treatment and women's physical and psychological health and wellness.
Harrison, Carmel; Mond, Jonathan; Rieger, Elizabeth; Rodgers, Bryan
We sought to elucidate the nature and extent of impairment in quality of life a